Organization · Type 2 NPI

State of Mississippi - University of Mississippi M

Community/Retail Pharmacy · Jackson, MS

NPI number 1417090093 Active

Practice location

2500 N State St
Jackson, MS 39216-4500

Call (601) 984-6455 Map

Fax (601) 815-7640

Specialties and licenses

TaxonomyCodeLicense
Community/Retail Pharmacy Primary 3336C0003X02188 (MS)

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

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About NPI 1417090093

State of Mississippi - University of Mississippi M's National Provider Identifier is 1417090093, issued on Feb 14, 2007. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Jackson, MS. The record was last updated on Oct 15, 2026.