University Pavilion Pharmacy

NPI 1417090093 - Pharmacy - 3336C0002X

NPI Details
NPI 1417090093
Enumeration Date 02/14/2007
Last Updated 09/07/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name SUSAN HARTNESS SUSAN
Position PHARMACY SUPERVISOR
Phone (601) 984-2058
Fax (601) 984-2063
Practice Location
1410 E WOODROW WILSON DR
JACKSON MS, 39216, US
Phone (601) 984-2058
Fax (601) 984-2063
Business Location
1410 E WOODROW WILSON DR
JACKSON MS, 39216, US
Phone (601) 984-2058
Fax (601) 984-2063
Toxanomy
Taxonomy Code 3336C0002X
License State Mississippi
License Number 02188
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According to our database, University Pavilion Pharmacy NPI is 1417090093, taxonomy code is 3336C0002X and license number is 02188, license state is located at Mississippi. University Pavilion Pharmacy physically located at 1410 E Woodrow Wilson Dr, Jackson MS, 39216. NPI Number 1033115704 has the healthcare provider type.

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1417090093 NPI number is provided on an as is basis without warranty of any kind. 1417090093 is maintained by the National Plan & Provider Enumeration System. The contents of University Pavilion Pharmacy are for informational purposes only.