Crossroads Care Pharmacy LLC

Organization Active NPI Community/Retail Pharmacy · Bainbridge, IN

NPI 1003332495 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1003332495
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
CROSSROADS CARE PHARMACY LLC
Practice address
209 East Pat Rady Way
Suite B
Bainbridge, IN 46105
Phone
(765) 522-4300
Fax
(765) 522-4303
NPI assigned
Aug 17, 2017
Organization subpart
No

Authorized official

Name
Mrs. Amanda Louise Laney
Title
Owner, Member
Phone
(765) 720-2569

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20180913002308 IN Part B Supplier - Mass Immunization (Roster Biller Only) 6901172733 Practice locations: Bainbridge, IN

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Yes

Addresses

Primary practice location

209 East Pat Rady Way
Suite B
Bainbridge, IN 46105

Mailing address

6176 S County Road 250 E
Greencastle, IN 46135-8728
Phone (765) 795-7611

Other practice location 1

509 East Pat Rady Way
Suite B
Bainbridge, IN 46105
Phone (765) 522-4300

Other providers in Bainbridge, IN

All providers in Bainbridge, IN · Community/Retail Pharmacy in Indiana

Sources for this page

Verify at the official NPI Registry.