Individual provider Active NPI

Charles Louis Wilson, RPH

  • Pharmacist
  • Mount Pleasant, TX
National Provider Identifier
1245439629
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
22248 Issued in TX
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

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
22248TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.