Crossroads Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

27009 Issued in TX

Legal business name

CROSSROADS PHARMACY

Practice address

3220 Gus Thomasson Rd Ste 237
Mesquite, TX 75150-4051

Phone

(214) 308-1963

Fax

(214) 432-8274

NPI assigned

Jul 17, 2010

Organization subpart

No

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

Authorized official

Name

O'Rita SiddallNPI 1497009070

Title

Pharmacy Manager

Phone

(214) 308-1963

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• CrossRoads Pharmacy, LLC Doing business as

Locations

Practitioners 1

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

• Orita Siddall, PHARMD

  • Pharmacist
  • Mesquite, TX
  • NPI 1497009070
  NPD (past) Authorized official

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

{
    "created_epoch": "1279324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450656000000",
    "number": "1184937286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 271402",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752279579",
            "telephone_number": "214-308-1963",
            "fax_number": "214-432-8274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 GUS THOMASSON RD STE 237",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751504051",
            "telephone_number": "214-308-1963",
            "fax_number": "214-432-8274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-17",
        "last_updated": "2015-12-21",
        "status": "A",
        "authorized_official_last_name": "SIDDALL",
        "authorized_official_first_name": "O'RITA",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "214-308-1963"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "27009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2126598",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CrossRoads Pharmacy, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.