# STATE OF MISSISSIPPI - UNIVERSITY OF MISSISSIPPI MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** UMHC Care Clinic Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649419532
- **Authorized official:** JEFFREY GRIMSLEY (ASSOCIATE CFO - CLINICAL OPERATIONS)
- **Authorized official phone:** (601) 815-6270

## Contact information

- **Practice address:** 2500 N STATE ST, H120, JACKSON, MS 39216-4500
- **Practice address phone:** (601) 815-1686
- **Practice address fax:** (601) 815-1689
- **Mailing address:** 2500 N STATE ST, H120, JACKSON, MS 39216-4500
- **Mailing address phone:** (601) 815-1686
- **Mailing address fax:** (601) 815-1689

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 07796/05.1 | MS | Yes |

## Other

- **Enumeration date:** 02/17/2009
- **Last updated:** 02/13/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2119027 | PK | — |