Provider Demographics
NPI:1831286061
Name:CROSS MEDICAL
Entity type:Organization
Organization Name:CROSS MEDICAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:LARRY
Authorized Official - Last Name:CASH
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:256-238-1444
Mailing Address - Street 1:730 LEIGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5746
Mailing Address - Country:US
Mailing Address - Phone:256-238-1444
Mailing Address - Fax:256-238-8013
Practice Address - Street 1:730 LEIGHTON AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5746
Practice Address - Country:US
Practice Address - Phone:256-238-1444
Practice Address - Fax:256-238-8013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL132332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51053891OtherBLUE CROSS BLUE SHIELD
AL0210650001Medicare ID - Type UnspecifiedMEDICARE NUMBER