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General NPI Number Information
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NPI Number | 1902189848
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Entity Type | Individual
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Provider Name | HOLMES WARREN CROSS JR. PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 09/27/2011
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 790 WEST GRANADA BLVD. WALGREENS
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5178
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Country | US
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Telephone | 386-672-7107
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Fax | 386-673-2892
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Provider Business Mailing Address
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Address Line | 790 WEST GRANADA BLVD. WALGREENS
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5178
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Country | US
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Telephone | 386-672-7107
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Fax | 386-673-2892
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS21221
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License Number State | FL
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