Organization
EICCUA LLC
Active
Other names
WilsonValue Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
IJEOMA AGNES UWAKWE (PHARMACY MANAGER)
(252) 293-4177
Entity
Organization
Contact information
Practice address
404 NASH ST EAST, WILSON, NC 27893
(252) 293-4177
(252) 293-4180
Mailing address
404 NASH ST EAST, WILSON, NC 27893
(252) 293-4177
(252) 293-4180
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629477377
—
NC
Enumeration date
01/06/2023
Last updated
01/06/2023
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