Provider Demographics
NPI:1154006344
Name:SAPPHIRE ENTERPRISE
Entity type:Organization
Organization Name:SAPPHIRE ENTERPRISE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-606-4149
Mailing Address - Street 1:1221 BOWER PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-3734
Mailing Address - Country:US
Mailing Address - Phone:803-834-3183
Mailing Address - Fax:803-994-8367
Practice Address - Street 1:1221 BOWER PKWY STE 104
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-3734
Practice Address - Country:US
Practice Address - Phone:803-834-3183
Practice Address - Fax:803-994-8367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-16
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy