MEDICARE: GWM ENTERPRISES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	09116	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2065396	OTHER	PK

General Provider Information

NPI Number	:	1780782649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GWM ENTERPRISES INC

Provider Business Mailing Address
First Line	:	139 ELAMS RD
Second Line	:
City	:	LITTLETON
State	:	NC
Zip	:	27850-8479
Country	:	US
Telephone Number	:	252-586-3836
Fax Number	:	252-586-2348

Provider Business Practice Location Address
First Line	:	139 ELAMS RD
Second Line	:
City	:	LITTLETON
State	:	NC
Zip	:	27850-8479
Country	:	US
Telephone Number	:	252-586-3836
Fax Number	:	252-586-2348

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	ANDREW HUGGINS
Credential	:	PHARMD
Telephone Number	:	252-519-1144

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	02/14/2017

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Directions to “GWM ENTERPRISES INC ” Practice Location

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