Polk'S Crossgate Discount Drugs Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

112818 Issued in AL

Legal business name

POLK'S CROSSGATE DISCOUNT DRUGS INC.

Doing business as

PMO PHARMACY MGMT DOTHAN

Practice address

3119 Wesley Way Ste 6
Ste 6
Dothan, AL 36305-2000

Phone

(334) 699-3900

Fax

(334) 699-3902

NPI assigned

Jul 14, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Margaret Hudson, RPH

Title

Managing Pharmacist

Phone

(334) 699-3900

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• PMO PHARMACY MGMT DOTHAN Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1407872666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3119 WESLEY WAY",
            "address_2": "STE 6",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363052002",
            "telephone_number": "334-699-3900",
            "fax_number": "334-699-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3119 WESLEY WAY STE 6",
            "address_2": "STE 6",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363052000",
            "telephone_number": "334-699-3900",
            "fax_number": "334-699-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK'S CROSSGATE DISCOUNT DRUGS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "MANAGING PHARMACIST",
        "authorized_official_telephone_number": "334-699-3900",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "112818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003723",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1995930",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031628800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "794290082A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PMO PHARMACY MGMT DOTHAN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Dothan, AL
• Providers in Dothan, AL by specialty
• Community/Retail Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.