# POLK'S CROSSGATE DISCOUNT DRUGS INC.

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

## Provider details

- **NPI number:** 1407872666
- **Authorized official:** MARGARET HUDSON RPH (MANAGING PHARMACIST)
- **Authorized official phone:** (334) 699-3900

## Contact information

- **Practice address:** 3119 WESLEY WAY STE 6, STE 6, DOTHAN, AL 36305-2000
- **Practice address phone:** (334) 699-3900
- **Practice address fax:** (334) 699-3902
- **Mailing address:** 3119 WESLEY WAY, STE 6, DOTHAN, AL 36305-2002
- **Mailing address phone:** (334) 699-3900
- **Mailing address fax:** (334) 699-3902

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 112818 | AL | Yes |

## Other

- **Enumeration date:** 07/14/2006
- **Last updated:** 04/12/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 031628800 | — | FL |
| 05 | — | 100003723 | — | AL |
| 01 | — | 1995930 | PK | — |
| 05 | — | 794290082A | — | GA |