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Organization
POLK'S CROSSGATE DISCOUNT DRUGS INC.
Active
Organization
POLK'S CROSSGATE DISCOUNT DRUGS INC.
Active
Other names
Polk's Discount Drugs #7
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS SMITH (MANAGER)
(601) 940-0668
Entity
Organization
Contact information
Practice address
1031 STAR RD, BRANDON, MS 39042-9010
(601) 825-4507
(601) 825-4524
Mailing address
1031 STAR RD, BRANDON, MS 39042-9010
(601) 825-4507
(601) 825-4524
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
07891/01.2
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07308025
—
MS
01
—
2117242
PK
—
Enumeration date
10/02/2008
Last updated
02/20/2017
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