Eiccua LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

EICCUA LLC

Practice address

404 Nash St East
Wilson, NC 27893

Phone

(252) 293-4177

Fax

(252) 293-4180

NPI assigned

Jan 6, 2023

Organization subpart

No

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

Authorized official

Name

Ijeoma Agnes Uwakwe

Title

Pharmacy Manager

Phone

(252) 293-4177

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• WilsonValue Drug Store Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672963200000",
    "number": "1730893504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 NASH ST EAST",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "27893",
            "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 EAST",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "27893",
            "telephone_number": "252-293-4177",
            "fax_number": "252-293-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EICCUA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-04",
        "status": "A",
        "authorized_official_last_name": "UWAKWE",
        "authorized_official_first_name": "IJEOMA",
        "authorized_official_middle_name": "AGNES",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "252-293-4177"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629477377",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Fax",
            "affiliation": "N",
            "endpointDescription": "Fax and e-sccript",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "prescriptions and generic patient messages",
            "address_1": "404 Nash St East",
            "city": "Wilson",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "WilsonValue Drug Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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.
• Elena All Good Services LLC

• All providers in Wilson, NC
• Long Term Care Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.