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General NPI Number Information
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NPI Number | 1174563829
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Entity Type | Organization
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Legal Business Name | CROSBY PHARMACY INC
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 06/06/2022
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Provider Practice Location Address
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Address Line | 22629 TWAIN HARTE DR STE D
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City | TWAIN HARTE
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State | CA
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Zip | 95383-9405
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Country | US
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Telephone | 209-586-3225
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Fax | 209-586-3249
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Provider Business Mailing Address
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Address Line | PO BOX 128
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City | TWAIN HARTE
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State | CA
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Zip | 95383-0128
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Country | US
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Telephone | 209-586-3225
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Fax | 209-586-3249
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Authorized Official
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Title or Position | OWNER
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Name | PATRICK CROSBY
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Credential | RPH
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Telephone | 209-586-3225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY55899
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License Number State | CA
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