University Pavilion Pharmacy

LBN: University Pavilion Pharmacy
University Pavilion Pharmacy is an health care organization with primary practice located at 1410 E Woodrow Wilson Dr , Jackson MS 39216. The organization recently has only one registered license in Suppliers / Clinic Pharmacy, which is considered as the primary health care specialty. University Pavilion Pharmacy can be contacted via phone (601) 984-2058, or through Cobb, Susan Hartness via phone (601) 984-2058.

Contact Information

Primary practice address
1410 E Woodrow Wilson Dr Jackson MS 39216
Phone: (601) 984-2058
Fax: (601) 984-2063
Website:
Map and Directions
Authorized official contact:
Name: Cobb, Susan Hartness R.PH.
Phone: (601) 984-2058

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Clinic Pharmacy 3336C0002X 02188 Mississippi

Profile Details

NPI number 1417090093
LBN Legal business name University Pavilion Pharmacy
DBA Doing business as
Authorized official Cobb, Susan Hartness R.PH.
Entity Organization
Organization subpart 1 No
Enumeration date Feb 14th, 2007
Last updated Sep 7th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417090093 NPPES
Mississippi MEDICAID 30158

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