MEDICARE: CROSSVILLE DRUGS INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	25 02907	AL

General Provider Information

NPI Number	:	1457475444
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CROSSVILLE DRUGS INC.

Provider Business Mailing Address
First Line	:	PO BOX 37
Second Line	:
City	:	CROSSVILLE
State	:	AL
Zip	:	35962-0037
Country	:	US
Telephone Number	:	256-528-7124
Fax Number	:

Provider Business Practice Location Address
First Line	:	15192 AL HIGHWAY 68
Second Line	:
City	:	CROSSVILLE
State	:	AL
Zip	:	35962-3452
Country	:	US
Telephone Number	:	256-528-7124
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	JAMES A GARDNER
Credential	:	RPH
Telephone Number	:	256-528-7124

Provider Enumeration Date	:	03/17/2007
Last Update Date	:	10/29/2014

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Directions to “CROSSVILLE DRUGS INC. ” Practice Location

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