Provider Demographics
NPI:1326886847
Name:CROSSROAD PHARMACY
Entity type:Organization
Organization Name:CROSSROAD PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BERRENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-707-5755
Mailing Address - Street 1:5 E LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-8202
Mailing Address - Country:US
Mailing Address - Phone:513-381-2247
Mailing Address - Fax:
Practice Address - Street 1:5 E LIBERTY ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-8202
Practice Address - Country:US
Practice Address - Phone:513-381-2247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTIAN COMMUNITY HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy