Wises Drug Store Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH374 Issued in FL

Legal business name

WISES DRUG STORE INC

Doing business as

Wise's Pharmacy

Practice address

708 SW 4TH Ave
Gainesville, FL 32601-6427

Phone

(352) 376-8286

Fax

(352) 374-3799

NPI assigned

Feb 8, 2007

Organization subpart

No

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

Authorized official

Name

Edgar H Wise III

Title

President

Phone

(904) 727-8362

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Wise's Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Wise'S Drugstore2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wise'S Drugstore

  • Durable Medical Equipment & Medical Supplies
  • Gainesville, FL
  • NPI 1184719361
  NPD tax ID

Locations

Practitioners 1

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

• Kenneth Edgar Wise, PHARM. D

  • Pharmacist
  • Gainesville, FL
  • NPI 1861785560
  NPD

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1942340864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 SW 4TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326016427",
            "telephone_number": "352-376-8286",
            "fax_number": "352-375-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 SW 4TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326016427",
            "telephone_number": "352-376-8286",
            "fax_number": "352-374-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISES DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-727-8362",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "673317498",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103626200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wise's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wise'S Drugstore
• Wise'S Parkwood
• Wisebuddha Enterprises
• John Gilbert Wiseheart, AU.D.
• Rebecca Maulden Wiseheart, M.A.
• John Edwin Witcher, DMD, MS
• Michael Robert Withee, LMT
• Miriam Witherspoon
• Marie Christine Withrow, PA-C
• Danielle Witkowski, CRNA

• Community/Retail Pharmacy in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.