Crossroads Medical Supply, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

06937/11.1 Issued in MS

Legal business name

CROSSROADS MEDICAL SUPPLY, INC

Practice address

203 Alcorn Drive
Corinth, MS 38834

Phone

(662) 286-8222

Fax

(662) 286-8333

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Steven S. Dalton

Title

Owner

Phone

(662) 286-8222

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992890578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 ALCORN DRIVE",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "38834",
            "telephone_number": "662-286-8222",
            "fax_number": "662-286-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 ALCORN DRIVE",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "38834",
            "telephone_number": "662-286-8222",
            "fax_number": "662-286-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS MEDICAL SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DALTON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-286-8222"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "06937/11.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4582405",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kaylee Crump, M.S. SLP-CF
• Marissa Ordonez Cruz, D.O.
• Crystalcare
• James Ronald Cummins, D.M.D.
• Ashleigh Wilson Dalton, P.T.

• Durable Medical Equipment & Medical Supplies in Corinth, MS
• Providers in Corinth, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.