G. Wilson Enterprise,Inc.

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH018959 Issued in GA

Legal business name

G. WILSON ENTERPRISE,INC.

Doing business as

The Medicine Shoppe Pharmacy #1774

Practice address

2416 Windsor Spring Rd
Augusta, GA 30906-4666

Phone

(706) 772-7155

Fax

(706) 772-7149

NPI assigned

Feb 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Griselda Wilson, PHARMDNPI 1407801566

Title

Pharmacist,Owner

Phone

(706) 772-7155

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• The Medicine Shoppe Pharmacy #1774 Doing business as

Locations

Practitioners 1

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

• Griselda Wilson, PHARMD

  • Pharmacist
  • Augusta, GA
  • NPI 1407801566
  NPD (past) Authorized official

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689715930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 WINDSOR SPRING RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309064666",
            "telephone_number": "706-772-7155",
            "fax_number": "706-772-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2416 WINDSOR SPRING RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309064666",
            "telephone_number": "706-772-7155",
            "fax_number": "706-772-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G. WILSON ENTERPRISE,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "GRISELDA",
        "authorized_official_title_or_position": "PHARMACIST,OWNER",
        "authorized_official_telephone_number": "706-772-7155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH018959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00921566A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI PROVIDER",
            "identifier": "1407801566",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7G8531",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medicine Shoppe Pharmacy #1774",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacist in Augusta, GA
• Providers in Augusta, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.