Healthcare Provider Details

I. General information

NPI: 1487683355
Provider Name (Legal Business Name): CROSSROADS PHARMACY & GIFT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 OXFORD ST
HANOVER TOWNSHIP PA
18706-3338
US

IV. Provider business mailing address

135 OXFORD ST
HANOVER TOWNSHIP PA
18706-3338
US

V. Phone/Fax

Practice location:
  • Phone: 570-825-4566
  • Fax: 570-824-9090
Mailing address:
  • Phone: 570-825-4566
  • Fax: 570-824-9090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN JOSEPH KEMPINSKI
Title or Position: TREASURER
Credential: RPH.
Phone: 570-825-4566