Provider Demographics
NPI:1689691206
Name:HEALTHWISE PHARMACY OF GREENVILLE INC
Entity Type:Organization
Organization Name:HEALTHWISE PHARMACY OF GREENVILLE INC
Other - Org Name:THERAPEUTIC SOLUTIONS HOME INFUSION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-752-0338
Mailing Address - Street 1:615B S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-2856
Mailing Address - Country:US
Mailing Address - Phone:252-295-0060
Mailing Address - Fax:252-752-4555
Practice Address - Street 1:615B S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2856
Practice Address - Country:US
Practice Address - Phone:252-295-0060
Practice Address - Fax:252-752-4555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
NC126513336H0001X
NC88293336H0001X, 3336L0003X, 3336S0011X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2153575OtherPK
200636301OtherBLACKLUNG DME
NC1239790001Medicare NSC
NC2801178Medicare ID - Type UnspecifiedPART B
NC0440NOtherBCBS DME
NC047J2OtherBCBS OF NC
NC0745837Medicaid
NC7702602Medicaid