Crosby Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY55899 Issued in CA

Legal business name

CROSBY PHARMACY INC

Doing business as

Twain Harte Pharmacy

Practice address

22629 Twain Harte Dr Ste D
Twain Harte, CA 95383-9405

Phone

(209) 586-3225

Fax

(209) 586-3249

NPI assigned

Jun 8, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Patrick Crosby, RPHNPI 1235341603

Title

Owner

Phone

(209) 586-3225

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Twain Harte Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Patrick Kenan Crosby, RPH

  • Pharmacist
  • Groveland, CA
  • NPI 1235341603
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654473600000",
    "number": "1174563829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 128",
            "city": "TWAIN HARTE",
            "state": "CA",
            "postal_code": "953830128",
            "telephone_number": "209-586-3225",
            "fax_number": "209-586-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22629 TWAIN HARTE DR STE D",
            "city": "TWAIN HARTE",
            "state": "CA",
            "postal_code": "953839405",
            "telephone_number": "209-586-3225",
            "fax_number": "209-586-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSBY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A",
        "authorized_official_last_name": "CROSBY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-586-3225",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY55899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA225520",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2001272",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Twain Harte Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Darlene Brunel, RDH
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• David A Hartwig, P.T.
• Ashely Anne Hayes, R.D.H

• Community/Retail Pharmacy in Twain Harte, CA
• Providers in Twain Harte, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.