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
—
—
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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