UNIVERSITY PAVILION PHARMACY – NPI #1417090093
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.

Health Care Provider Taxonomy Code for Pharmacy

UNIVERSITY PAVILION PHARMACY is a pharmacy located in JACKSON, MS. NPPES has assigned the NPI number 1417090093 to UNIVERSITY PAVILION PHARMACY on February 14, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 3336C0002X from the Health Care Provider Taxonomy code set, which is classified as Pharmacy, specializing in Clinic Pharmacy

The NPI profile was previously updated about 19 years ago on Sep 07, 2007. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for UNIVERSITY PAVILION PHARMACY below.

NPI Profile for
UNIVERSITY PAVILION PHARMACY

NPI Number
1417090093
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
UNIVERSITY PAVILION PHARMACY
Primary location
1410 E WOODROW WILSON DR
JACKSON, MS 39216
Phone: (601) 984-2058 Fax: (601) 984-2063
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
SUSAN COBB
PHARMACY SUPERVISOR
Phone: (601) 984-2058
Updated
Identifiers

Identifiers for UNIVERSITY PAVILION PHARMACY

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDMS30158
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
3336C0002X
- Pharmacy / Clinic Pharmacy (Primary)		 MS 02188

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.