Organization
GENE POLKS INC
Active
Other names
GENE POLKS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BRINSON POLK RPH (OWNER)
(601) 849-2533
Entity
Organization
Contact information
Practice address
406 SIMPSON HIGHWAY 149, MAGEE, MS 39111-3416
(601) 849-2532
(601) 849-2558
Mailing address
406 SIMPSON HIGHWAY 149, MAGEE, MS 39111-3416
(601) 849-2532
(601) 849-2558
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
00445/1.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0033740
—
MS
01
—
2043293
PK
—
Enumeration date
08/10/2006
Last updated
12/01/2016
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