Provider Demographics
NPI:1811125891
Name:THOMAS R. CROSS
Entity type:Organization
Organization Name:THOMAS R. CROSS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:602-283-5020
Mailing Address - Street 1:3519 W SAHUARO DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4041
Mailing Address - Country:US
Mailing Address - Phone:602-283-5020
Mailing Address - Fax:602-674-5259
Practice Address - Street 1:3519 W SAHUARO DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4041
Practice Address - Country:US
Practice Address - Phone:602-283-5020
Practice Address - Fax:602-674-5259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care