Active NPI
Healthwise Pharmacy of Greenville Inc
- Community/Retail Pharmacy
- Greenville, NC
National Provider Identifier
1104818475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 07225
- Legal business name
- HEALTHWISE PHARMACY OF GREENVILLE INC
- Doing business as
- HEALTHWISE PHARMACY
- Practice address
- 615B S Memorial Dr
Greenville, NC 27834-2856 - Phone
- (252) 752-0338
- Fax
- (252) 752-4555
- NPI assigned
- Aug 22, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Marcie Parker, PHARMD
- Title
- President
- Phone
- (252) 752-0338
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 07225 | NC | Primary |
| Compounding Pharmacy | 3336C0004X | |||
| Specialty Pharmacy | 3336S0011X |
Addresses
Primary practice location
615B S Memorial Dr
Greenville, NC 27834-2856
Mailing address
615B S Memorial Dr
Greenville, NC 27834-2856
Phone (252) 752-0338
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104818475 | Medicaid | NC | |
| 2072306 | Other | PK |
Other names 1
- HEALTHWISE PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050914000173 | NC | Part B Supplier - Mass Immunization (Roster Biller Only) | 4688607310 | Practice locations: Greenville, NC |
| O20100930061607 | NC | DME Supplier - Pharmacy | 4688607310 |
1 other NPI on this enrollment Practice locations: Greenville, NC |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Home Infusion Therapy Pharmacy
- Greenville, NC
- NPI 1689691206
4688607310
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Home Infusion Therapy Pharmacy
- Greenville, NC
- NPI 1689691206
O20100930061607
National Provider Directory
National Provider Directory- Tax ID family
- Therapeutic Solutions Vital
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Hookerton, NC
- NPI 1609131283
-
- Long Term Care Pharmacy
- Greenville, NC
- NPI 1679337778
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Greenville, NC
- NPI 1871473272
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124668800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1648598400000",
"number": "1104818475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615B S MEMORIAL DR",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278342856",
"telephone_number": "252-752-0338",
"fax_number": "252-752-4555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615B S MEMORIAL DR",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278342856",
"telephone_number": "252-752-0338",
"fax_number": "252-752-4555"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEALTHWISE PHARMACY OF GREENVILLE INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-22",
"last_updated": "2022-03-30",
"certification_date": "2022-03-30",
"status": "A",
"authorized_official_last_name": "PARKER",
"authorized_official_first_name": "MARCIE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "252-752-0338",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NC",
"license": "07225",
"primary": true
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1104818475",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2072306",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "HEALTHWISE PHARMACY",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "HEALTHWISE PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.