Healthcare Provider Details

I. General information

NPI: 1174637144
Provider Name (Legal Business Name): MEDICROSS PHARMACEUTICAL SVCS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 S SAN MATEO DR
SAN MATEO CA
94401-3803
US

IV. Provider business mailing address

11 S SAN MATEO DR
SAN MATEO CA
94401-3803
US

V. Phone/Fax

Practice location:
  • Phone: 650-347-5251
  • Fax: 650-348-0509
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY46847
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: FRANK TSOLAKIS
Title or Position: OWNER AND PHARMACIST IN CHARGE
Credential: PHARMD
Phone: 650-347-5251