Provider Demographics
NPI:1831065911
Name:POLKS CROSSGATE DISCOUNT DRUGS INC
Entity type:Organization
Organization Name:POLKS CROSSGATE DISCOUNT DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-825-8660
Mailing Address - Street 1:207 KLONDYKE RD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:MS
Mailing Address - Zip Code:39560-4640
Mailing Address - Country:US
Mailing Address - Phone:228-290-6090
Mailing Address - Fax:
Practice Address - Street 1:207 KLONDYKE RD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:MS
Practice Address - Zip Code:39560-4640
Practice Address - Country:US
Practice Address - Phone:228-290-6090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POLK'S CROSSGATE DISCOUNT DRUGS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy