Provider Demographics
NPI:1154051050
Name:CROSETTI HEALTH AND WELLNESS INC
Entity type:Organization
Organization Name:CROSETTI HEALTH AND WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CROSETTI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:816-847-6930
Mailing Address - Street 1:510 S MAIN ST
Mailing Address - Street 2:PO BOX 2983
Mailing Address - City:GRAIN VALLEY
Mailing Address - State:MO
Mailing Address - Zip Code:64029
Mailing Address - Country:US
Mailing Address - Phone:816-847-6930
Mailing Address - Fax:
Practice Address - Street 1:510 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAIN VALLEY
Practice Address - State:MO
Practice Address - Zip Code:64029-9701
Practice Address - Country:US
Practice Address - Phone:816-847-2682
Practice Address - Fax:816-847-2682
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CROSETTI HEALTH AND WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy