Wise Pharmacy LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

033563 Issued in NY

Legal business name

WISE PHARMACY LLC

Practice address

189-01 Linden Blvd
Saint Albans, NY 11412

Phone

(718) 978-6168

NPI assigned

May 28, 2015

Last updated

May 28, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adnan Shahid

Title

President

Phone

(718) 978-6168

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432771200000",
    "number": "1790164374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18901 LINDEN BLVD",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114123330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189-01 LINDEN BLVD",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "11412",
            "telephone_number": "718-978-6168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-28",
        "last_updated": "2015-05-28",
        "status": "A",
        "authorized_official_last_name": "SHAHID",
        "authorized_official_first_name": "ADNAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-978-6168"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NY",
            "license": "033563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keisha Williams
• Lakisha K Williams
• Patrice Williams, RN
• Shareece Williams
• Andrew Willner
• Pamela Ceclia Worrell-Springer, RN
• Shawn Jamel Wright, FNP- BC
• Fay L. Young
• Jennae Young, MS.ED
• Julie Young

• Health Maintenance Organization in Saint Albans, NY
• Providers in Saint Albans, NY by specialty
• Health Maintenance Organization in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; 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.