Individual provider Active NPI

Kwasi Wiredu

  • Pharmacist
  • Dillon, SC
National Provider Identifier
1134538176
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
35579 Issued in SC
Practice address
805 Enterprise Rd
Dillon, SC 29536-7821
Phone
(843) 841-2228
Fax
(843) 841-0294
NPI assigned
Aug 4, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 35579 SC Primary

Addresses

Primary practice location

805 Enterprise Rd
Dillon, SC 29536-7821

Mailing address

332 Orangepark Dr
Orangeburg, SC 29115-2200
Phone (843) 822-1456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35579SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East, LP Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1134538176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 ORANGEPARK DR",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291152200",
            "telephone_number": "843-822-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 ENTERPRISE RD",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295367821",
            "telephone_number": "843-841-2228",
            "fax_number": "843-841-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIREDU",
        "first_name": "KWASI",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-04",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "35579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dillon, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.