Omnisalus Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

13181 Issued in NC

Legal business name

OMNISALUS INC

Practice address

3110 New Bern Ave Ste 108
Raleigh, NC 27610-1200

Phone

(919) 703-0717

Fax

(919) 703-0861

NPI assigned

Oct 20, 2016

Organization subpart

No

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

Authorized official

Name

Elvis Tanyi, PHARM.D, MBA

Title

Pharmacy Director

Phone

(919) 757-8290

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• City pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518652800000",
    "number": "1013468370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 NEW BERN AVE STE 108",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101200",
            "telephone_number": "919-703-0717",
            "fax_number": "919-703-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 NEW BERN AVE STE 108",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101200",
            "telephone_number": "919-703-0717",
            "fax_number": "919-703-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNISALUS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-20",
        "last_updated": "2018-02-15",
        "status": "A",
        "authorized_official_last_name": "TANYI",
        "authorized_official_first_name": "ELVIS",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "919-757-8290",
        "authorized_official_credential": "PHARM.D, MBA"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "19478",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "13181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167484",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Omni Family of Services North Carolina Inc.
• Omni Point LLC
• Omni Visions, Inc
• Omni Visions, Inc.
• Omniflight Helicopters, Inc
• On Demand Logistics Co.
• On Site Dermatology of North Carolina, PLLC
• On the Horizon Counseling, PLLC
• On Track Behavioral Health Inc.
• Onc Care of NC II, LLC

• Community/Retail Pharmacy in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.