UNIVERSITY PAVILION PHARMACY (NPI# 1417090093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417090093 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY PAVILION PHARMACY |
| Practice Address |
1410 E Woodrow Wilson Dr Jackson MS 39216 |
| Practice Telephone | 6019842058 |
| Practice Fax Number | 6019842063 |
| Mailing Telephone | 6019842058 |
| Mailing Fax Number | 6019842063 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2007-09-07 |
| Authorized Official Name | MRS. SUSAN HARTNESS COBB (PHARMACY SUPERVISOR) |
| Authorized Official Telephone | 6019842058 |
| Authorized Official Credential | R.PH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
02188 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 30158 | 05 |
| Street Address |
1410 E WOODROW WILSON DR |
| City | JACKSON |
| State | MS |
| Zip Code | 39216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922319383 | Advance Pharmacy Services Pllc | Pharmacy | 317 N Parkway Ste 400, Jackson, TN 38305-2713 | 2010-06-30 |
| 1912452921 | Sports Medicine Pharmacy LLC | Pharmacy | 1325 E Fortification St, Jackson, MS 39202-2442 | 2016-08-19 |
| 1386863314 | State of Tennessee | Pharmacy | 295 Summar Dr, Jackson, TN 38301-3905 | 2007-04-25 |
| 1629109780 | Joint Venture Pharmacy, Inc. | Pharmacy | 280 Pattonsville Rd, Jackson, OH 45640-9452 | 2007-03-08 |
| 1831228618 | Jackson Clinic Pharmacy Inc | Pharmacy | 2863 Highway 45 Byp, Jackson, TN 38305-3618 | 2007-03-05 |
| 1477668416 | Jackson Clinic Pharmacy Inc | Pharmacy | 616 W Forest Ave, Jackson, TN 38301-3902 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518040500 | Region Iv Mh Mr Commission Phcy | Pharmacy | 2301b E Chambers Dr, Booneville, MS 38829 | 2006-10-23 |
| 1295268985 | Southern Pharmacy Clinical Management | Pharmacy | 3224 Dijon Ave, Ocean Springs, MS 39564-8520 | 2017-04-10 |
| 1689039711 | River Region Health System | Pharmacy | 2100 Highway 61 N, Pharmacy, Vicksburg, MS 39183-8211 | 2015-12-16 |
| 1891171351 | Prime Urgent Medical Clinic | Pharmacy | 176 Goodman Rd W, Southaven, MS 38671-9405 | 2015-08-07 |
| 1578956264 | Alliance Healthcare System | Pharmacy | 1938 Crescent Meadows Dr, Holly Springs, MS 38635-7419 | 2015-03-05 |
| 1871927517 | Southeast Mississippi Rural Health Initiative, Inc. | Pharmacy | 62 Old Airport Rd, Hattiesburg, MS 39401-8382 | 2013-08-29 |
| 1689915423 | Region Iv Desoto County Pharmacy | Pharmacy | 2705 Highway 51 S, Hernando, MS 38632-2634 | 2013-03-04 |
| 1740417922 | Coastal Family Health Center, Inc. | Pharmacy | 1025 Division St, Ste A, Biloxi, MS 39530-2906 | 2009-06-16 |
| 1508072273 | Foot Solutions LLC | Pharmacy | 120 Market St, Woodland, MS 39776-9104 | 2007-05-16 |
| 1750402798 | University of Southern Mississippi | Pharmacy | 118 College Dr, Ste 5066, Hattiesburg, MS 39406-0002 | 2007-04-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.