Organization
POLK'S CROSSGATE DISCOUNT DRUGS INC.
Active
Other names
POLK'S DISCOUNT DRUGS #5
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD SKELTON B.S. PHARMACY (MANAGER)
(601) 932-8609
Entity
Organization
Contact information
Practice address
1201 HIGHWAY 49 S, STE 2, RICHLAND, MS 39218-9425
(601) 932-8609
(601) 933-0024
Mailing address
PO BOX 180038, RICHLAND, MS 39218-0038
(601) 932-8609
(601) 933-0024
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
F02384
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00330041
—
MS
01
—
2045389
PK
—
Enumeration date
07/04/2006
Last updated
03/13/2017
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