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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