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Organization
STATE OF MISSISSIPPI UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Active
Organization
STATE OF MISSISSIPPI UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Active
Parent organization
STATE OF MISSISSIPPI UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Other names
University Hospital & Clinic HTC Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF MISSISSIPPI UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Authorized official
STEVEN V DANCER R.PH. (PHARMACY SUPERVISOR)
(601) 815-8902
Entity
Organization
Contact information
Practice address
350 W WOODROW WILSON AVE, 501, JACKSON, MS 39213-7681
(601) 815-3857
(601) 815-8901
Mailing address
350 W WOODROW WILSON AVE, 501, JACKSON, MS 39213-7681
(601) 815-3857
(601) 815-8901
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
06430
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01177235
—
MS
Enumeration date
02/16/2007
Last updated
12/19/2012
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