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Organization
POLK'S CROSSGATES DISCOUNT DRUGS INC.
Active
Organization
POLK'S CROSSGATES DISCOUNT DRUGS INC.
Active
Other names
PMO PHARMACY MANAGENMENT
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENDALL PARKS JONES JR. (MANAGER)
(601) 420-5150
Entity
Organization
Contact information
Practice address
319 CROSS PARK DR, JACKSON, MS 39208-8905
(601) 420-5150
(601) 420-5502
Mailing address
319 CROSSPARK DR, JACKSON, MS 39208
(601) 420-5150
(601) 420-5502
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
04134
MS
333600000X
Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00330604
—
MS
05
—
00440744
—
MS
05
—
1264474
—
LA
Enumeration date
08/04/2006
Last updated
12/18/2012
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