NPIMap

Organization Active NPI

State of Mississippi-University of Mississippi Medical Center

Doing business as University Hospital & Clinics Pharmacy

  • Pharmacy
  • Jackson, MS
National Provider Identifier
1932144342
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
04116 Issued in MS
Legal business name
STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Doing business as
University Hospital & Clinics Pharmacy
Practice address
350 W Woodrow Wilson Ave
Suite 501
Jackson, MS 39213-7681
Phone
(601) 815-3857
Fax
(601) 815-8901
NPI assigned
Jun 19, 2006
Last updated
Nov 11, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER UNIVERSIAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Steven Dancer, PHARM.D.
Title
Assistant Director of Pharmacy
Phone
(601) 815-8902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 04116 MS Primary

Addresses

Primary practice location

350 W Woodrow Wilson Ave
Suite 501
Jackson, MS 39213-7681

Mailing address

350 W Woodrow Wilson Ave
Suite 501
Jackson, MS 39213-7681
Phone (601) 815-3857

Other names 1

  • University Hospital & Clinics Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090414000575 MS Part B Supplier - Clinic/Group Practice 1850293036 Receives reassigned benefits from 1,922 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20100930058705 MS DME Supplier - Pharmacy 1850293036 Practice locations: Jackson, MS

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Sigurds O Krolls MD62 organizations share this tax ID, including this one
Part of
Sigurds O Krolls MD

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Locations

350 W Woodrow Wilson Ave
Ste 501
Jackson, MS 39213
Phone (601) 815-3857

Ownership & related parties

All facility ownership & control disclosures 15

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
State of Mississippi-University of Mississippi Medical CenterJackson, MS, CCN 250001 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jul 1, 2007
Jul 1, 2007
University of Mississi Medical Center- Holmes CountyLexington, MS, CCN 25Z319 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 2004
Holmes County Hospital & ClinicsLexington, MS, CCN 251319 Hospital 5% Or Greater Direct Ownership Interest Oct 1, 2004
Ummc- GrenadaGrenada, MS, CCN 250168 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Feb 21, 2014
Feb 21, 2014
Ummc MadisonCanton, MS, CCN 250038 Hospital 5% Or Greater Direct Ownership Interest (100%) May 1, 2025
Ummc MadisonCanton, MS, CCN 25U038 Hospital 5% Or Greater Direct Ownership Interest (100%) May 1, 2025
Lexington Rural Health ClinicLexington, MS, CCN 253813 Rural health clinic 5% Or Greater Direct Ownership Interest May 23, 2013
West Rural Health ClinicWest, MS, CCN 253812 Rural health clinic 5% Or Greater Direct Ownership Interest May 22, 2013
Ummc- Grenada Women's ServicesGrenada, MS, CCN 258626 Rural health clinic 5% Or Greater Direct Ownership Interest Jan 1, 2014
Holmes County Family Medicine Clinic- VaidenVaiden, MS, CCN 258625 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2016
Ummc Grenada Specialty PediatricsGrenada, MS, CCN 258627 Rural health clinic 5% Or Greater Direct Ownership Interest Jan 1, 2014
Children's of Mississippi Greenwood ClinicGreenwood, MS, CCN 258682 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2023
Ummc Greenwood Primary Care ClinicGreenwood, MS, CCN 258679 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2023
Ummc Greenwood Women's ClinicGreenwood, MS, CCN 258680 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2023
Ummc Grenada Primary Medicine ClinicGrenada, MS, CCN 258681 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2023

Owned or controlled facilities with NPI records 16

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605052800000",
    "number": "1932144342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W WOODROW WILSON AVE",
            "address_2": "SUITE 501",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392137681",
            "telephone_number": "601-815-3857",
            "fax_number": "601-815-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W WOODROW WILSON AVE",
            "address_2": "SUITE 501",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392137681",
            "telephone_number": "601-815-3857",
            "fax_number": "601-815-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER UNIVERSI",
        "enumeration_date": "2006-06-19",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A",
        "authorized_official_last_name": "DANCER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "601-815-8902",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MS",
            "license": "04116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Hospital & Clinics Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University Hospital & Clinics Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.