Organization
HEALTHWISE PHARMACY LLC
Active
Other names
Giant Genie Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUSTIN TYLER WISE PHARMD (OWNER)
(704) 814-0154
Entity
Organization
Contact information
Practice address
2925 SENNA DR STE 100, MATTHEWS, NC 28105-0512
(704) 814-0154
(704) 814-0520
Mailing address
2925 SENNA DR STE 100, MATTHEWS, NC 28105-0512
(704) 814-0154
(704) 814-0520
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
602467
—
NC
Enumeration date
02/01/2019
Last updated
02/02/2019
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