NPIMap

Organization Active NPI

Welvista

  • Community/Retail Pharmacy
  • Columbia, SC
National Provider Identifier
1023200441
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
10219 Issued in SC
Legal business name
WELVISTA
Practice address
2700 Middleburg Dr Ste 108
Columbia, SC 29204-2416
Phone
(803) 933-9183
Fax
(803) 254-0892
NPI assigned
Aug 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Authorized official

Name
Juanita Wright
Title
Chief Executive Officer
Phone
(803) 933-9183

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 10219 SC Primary

Addresses

Primary practice location

2700 Middleburg Dr Ste 108
Columbia, SC 29204-2416

Mailing address

2700 Middleburg Dr Ste 108
Columbia, SC 29204-2416
Phone (803) 933-9183

Other identifiers 2

IdentifierTypeStateIssuer
2093414OtherPK
710219MedicaidSC

Other names 1

  • WELVISTA Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Welvista7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2700 Middleburg Dr
Ste 108
Columbia, SC 29204
Phone (803) 933-9183

NPI Registry JSON

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433289600000",
    "number": "1023200441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 MIDDLEBURG DR STE 108",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042416",
            "telephone_number": "803-933-9183",
            "fax_number": "803-254-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 MIDDLEBURG DR STE 108",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042416",
            "telephone_number": "803-933-9183",
            "fax_number": "803-254-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELVISTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-10",
        "last_updated": "2015-06-03",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "803-933-9183"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "10219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2093414",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "710219",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WELVISTA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.