Healthcare Provider Details

I. General information

NPI: 1770402125
Provider Name (Legal Business Name): COSTWISE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 WASHINGTON ST
WILLIAMSTON NC
27892-2648
US

IV. Provider business mailing address

365 PAMLICO ST
BELHAVEN NC
27810-1419
US

V. Phone/Fax

Practice location:
  • Phone: 252-809-4288
  • Fax: 252-809-4287
Mailing address:
  • Phone: 252-809-4288
  • Fax: 252-809-4287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: WALTON P ONEAL III
Title or Position: OWNER
Credential: PHARMD
Phone: 252-943-1913