Active NPI
Charles Louis Wilson, RPH
- Pharmacist
- Mount Pleasant, TX
National Provider Identifier
1245439629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 22248
- Practice address
- 609 N Jefferson Ave
Mount Pleasant, TX 75455-3646 - Phone
- (903) 572-4397
- Fax
- (903) 572-5912
- NPI assigned
- Jul 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 22248 | TX | Primary |
Addresses
Primary practice location
609 N Jefferson Ave
Mount Pleasant, TX 75455-3646
Mailing address
1034 County Road 4221
Mount Pleasant, TX 75455-8173
Phone (903) 575-1817
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22248 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mt. Pleasant Pharmacy, Inc. | Past | Accepting new patients | |
| Mt Pleasant Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Specialty Pharmacy
- Mt Pleasant, TX
- NPI 1831294214
-
- Community/Retail Pharmacy
- Sulphur Springs, TX
- NPI 1962491357
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1245439629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1034 COUNTY ROAD 4221",
"city": "MOUNT PLEASANT",
"state": "TX",
"postal_code": "754558173",
"telephone_number": "903-575-1817",
"fax_number": "903-572-5912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "609 N JEFFERSON AVE",
"city": "MOUNT PLEASANT",
"state": "TX",
"postal_code": "754553646",
"telephone_number": "903-572-4397",
"fax_number": "903-572-5912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CHARLES",
"middle_name": "LOUIS",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-16",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "22248",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mount Pleasant, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.