Provider Demographics
NPI:1114928389
Name:CROSS, DEBORAH KAY (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:KAY
Last Name:CROSS
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 W MARKET ST
Mailing Address - Street 2:HILLCREST DRUG
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601
Mailing Address - Country:US
Mailing Address - Phone:423-926-2422
Mailing Address - Fax:423-926-0084
Practice Address - Street 1:714 W MARKET STREET
Practice Address - Street 2:HILLCREST DRUG
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601
Practice Address - Country:US
Practice Address - Phone:423-926-2422
Practice Address - Fax:423-926-0084
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNC3773183500000X
VA0202009943183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist