# POLK'S CROSSGATES DISCOUNT DRUGS INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PMO PHARMACY MANAGENMENT
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013925122
- **Authorized official:** MR. KENDALL PARKS JONES JR. (MANAGER)
- **Authorized official phone:** (601) 420-5150

## Contact information

- **Practice address:** 319 CROSS PARK DR, JACKSON, MS 39208-8905
- **Practice address phone:** (601) 420-5150
- **Practice address fax:** (601) 420-5502
- **Mailing address:** 319 CROSSPARK DR, JACKSON, MS 39208
- **Mailing address phone:** (601) 420-5150
- **Mailing address fax:** (601) 420-5502

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183700000X | Pharmacy Technician | 04134 | MS | — |
| 333600000X | Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/04/2006
- **Last updated:** 12/18/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00330604 | — | MS |
| 05 | — | 00440744 | — | MS |
| 05 | — | 1264474 | — | LA |