Provider Demographics
NPI:1225525041
Name:CROSBY PHARMACY AND WELLNESS
Entity type:Organization
Organization Name:CROSBY PHARMACY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:HERMIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:832-466-8267
Mailing Address - Street 1:15010 FM 2100 RD STE 210B1
Mailing Address - Street 2:
Mailing Address - City:CROSBY
Mailing Address - State:TX
Mailing Address - Zip Code:77532-9132
Mailing Address - Country:US
Mailing Address - Phone:281-462-7092
Mailing Address - Fax:281-462-7230
Practice Address - Street 1:15010 FM 2100 RD STE 210B1
Practice Address - Street 2:
Practice Address - City:CROSBY
Practice Address - State:TX
Practice Address - Zip Code:77532-9132
Practice Address - Country:US
Practice Address - Phone:281-462-7092
Practice Address - Fax:281-462-7230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX319213336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy