Eiccua LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

12073 Issued in NC

Legal business name

EICCUA LLC

Practice address

404 Nash St NE
Wilson, NC 27893-3743

Phone

(252) 293-4177

Fax

(252) 293-4180

NPI assigned

Aug 19, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Ijeoma Uwakwe, PHARM/DNPI 1932490497

Title

Pharmacist

Phone

(252) 293-4177

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• WilsonValue Drug Store Doing business as

Medicare fee-for-service enrollment

Enrolled in NC2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ijeoma Agnes Uwakwe, PHARM.D

  • Pharmacist
  • Wilson, NC
  • NPI 1932490497
  NPD (past) Authorized official

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

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1629477377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 NASH ST NE",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933743",
            "telephone_number": "252-293-4177",
            "fax_number": "252-293-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 NASH ST NE",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933743",
            "telephone_number": "252-293-4177",
            "fax_number": "252-293-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EICCUA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-19",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "UWAKWE",
        "authorized_official_first_name": "IJEOMA",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "252-293-4177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM/D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "12073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629477377",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WilsonValue Drug Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Claudia Smith Edmondson, PHARMD, MSCR, RPH
• Bradley Shane Edwards, COTA
• Gregory Eugene Edwards
• Ohiosumuan Chibuikem Ehimiaghe, DMD
• Eiccua LLC
• Eiccua LLC
• Rebecca L Eichner, DPT
• Patricia Louise Elder, P.T.
• Mark Eldridge, P.A.
• Elegant Ladies of the Future, Inc.

• All providers in Wilson, NC
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.

Verify at the official NPI Registry.