Active NPI
David Ephriam Wilson V, PHARMD
- Pharmacist
- Loris, SC
National Provider Identifier
1760083828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 29826
- Practice address
- 4099 Red Bluff Rd
Loris, SC 29569-6238 - Phone
- (732) 241-4228
- NPI assigned
- Nov 5, 2020
- 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 | 29826 | NC | Primary |
Addresses
Primary practice location
4099 Red Bluff Rd
Loris, SC 29569-6238
Mailing address
4099 Red Bluff Rd
Loris, SC 29569-6238
Phone (732) 241-4228
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29826 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604534400000",
"number": "1760083828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4099 RED BLUFF RD",
"city": "LORIS",
"state": "SC",
"postal_code": "295696238",
"telephone_number": "732-241-4228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4099 RED BLUFF RD",
"city": "LORIS",
"state": "SC",
"postal_code": "295696238",
"telephone_number": "732-241-4228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "DAVID",
"middle_name": "EPHRIAM",
"name_prefix": "Dr.",
"name_suffix": "V",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-05",
"last_updated": "2020-11-05",
"certification_date": "2020-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "29826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loris, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.