Provider Demographics
NPI:1821574682
Name:CRX, INC.
Entity Type:Organization
Organization Name:CRX, INC.
Other - Org Name:CROSSROADS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICKEY
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:WORTHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:910-207-1404
Mailing Address - Street 1:20 WHITEVILLE TOWN CTR
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-4401
Mailing Address - Country:US
Mailing Address - Phone:910-207-6369
Mailing Address - Fax:910-445-0240
Practice Address - Street 1:20 WHITEVILLE TOWN CTR
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472
Practice Address - Country:US
Practice Address - Phone:910-207-6369
Practice Address - Fax:910-445-0240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-16
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC137923336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy