University Pavilion Pharmacy
University Pavilion Pharmacy is a healthcare organization registered as Clinic Pharmacy in Jackson, MS, holding Type 2 (organization) NPI 1417090093 since 2007. The authorized official on file is Susan Cobb, Pharmacy Supervisor.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1417090093 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | University Pavilion Pharmacy |
| Practice address | 1410 E WOODROW WILSON DR, Jackson, MS, 39216 |
| Phone | 6019842058 |
| Fax | 6019842063 |
| Enumeration date | 2007-02-14 |
| Last updated in NPPES | 2007-09-07 |
Authorized official
| Name | Susan Cobb |
|---|---|
| Title | Pharmacy Supervisor |
| Phone | 6019842058 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 3336C0002X | Clinic Pharmacy | Primary | 02188 | MS |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30158 | Medicaid | MS | — |
Copy-ready billing details
Provider: University Pavilion Pharmacy NPI: 1417090093 Taxonomy: 3336C0002X (Clinic Pharmacy) Address: 1410 E WOODROW WILSON DR, Jackson, MS, 39216
Verify this record
Cross-check NPI 1417090093 against the authoritative CMS record: view University Pavilion Pharmacy on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Who is the authorized official for University Pavilion Pharmacy?
What is the NPI number for University Pavilion Pharmacy?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2007-09-07.