DWIGHT D. WALLACE (NPI# 1104245620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104245620 |
| Entity Type | Individual |
| Full Name | DWIGHT D. WALLACE |
| Credential | PHARMD |
| Practice Address |
44 S. Main St Aberdeen ID 83210 |
| Mailing Address |
Po Box 841 Aberdeen ID 83210-0841 |
| Practice Telephone | 2083974540 |
| Mailing Telephone | 2083974540 |
| Enumeration Date | 2014-04-11 |
| Last Update Date | 2014-04-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | P4895 | ID | Pharmacy Service Providers |
| Street Address |
44 S. MAIN ST |
| City | ABERDEEN |
| State | ID |
| Zip Code | 83210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497310866 | Natalie Fuss | Naturopath | 60 S. Main St., Aberdeen, ID 83210 | 2019-05-01 |
| 1366652166 | County of Bingham School Dist Aberdeen Class A | Local Education Agency (LEA) | 382 W Washington, Aberdeen, ID 83210 | 2007-05-23 |
| 1720125230 | Brent Tracy Schvaneveldt | Dentist | 81 West Washington, Aberdeen, ID 83210 | 2007-01-31 |
| 1730161399 | Debra S Mckay | Physician Assistant | 306 N Main, Aberdeen, ID 83210 | 2005-11-18 |
| 1790295095 | Nicholas Wiilliam Winn | Physician Assistant | 330 N Main St, Aberdeen, ID 83210 | 2017-10-02 |
| 1992239172 | Power County Hospital District | Public Health or Welfare | 50 South Main St, Aberdeen, ID 83210 | 2017-04-14 |
| 1073840401 | Heather Ann Schaper | Physician Assistant | 306 N Main St, Aberdeen, ID 83210-0000 | 2009-11-05 |
| 1306219928 | Velia Velasquez | Home Health Aide | 365 N Main Street, Aberdeen, ID 83210-0204 | 2015-11-04 |
| 1295734796 | Health West, Inc. | Family Medicine | 330 N Main, Aberdeen, ID 83210-0419 | 2005-07-18 |
| 1710038716 | Wallace Pharmacy Inc | Pharmacy | 44 S Main, Aberdeen, ID 83210-0841 | 2007-01-16 |
| Find all providers in zip 83210 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215537238 | Brant Haase | Pharmacist | 406 N 2nd St, Aberdeen, SD 57401-2707 | 2020-10-28 |
| 1154960821 | Sidney Steven Odom | Pharmacist | 105 Courtyard Cir, Aberdeen, NC 28315-3850 | 2019-12-30 |
| 1215579776 | Isabel Liberato | Pharmacist | 1129 Route 34, Aberdeen, NJ 07747-2166 | 2019-10-16 |
| 1265995823 | Quentin Clifford Bury | Pharmacist | 1409 6th Ave Se Ste 2, Aberdeen, SD 57401-4950 | 2019-04-10 |
| 1609309616 | Wende Benson | Pharmacist | 508 N Broadway St, Aberdeen, WA 98520-3934 | 2017-04-06 |
| 1407229149 | Randall T Higgins | Pharmacist | 17 Waverly Pl, Aberdeen, NJ 07747-1817 | 2015-11-03 |
| 1437583861 | Sevag Dishakjian | Pharmacist | 11109 Us 15-501, Unit 1804, Aberdeen, NC 28315-2306 | 2013-08-21 |
| 1952733164 | Marija Mikulskis Cavana | Pharmacist | 11109 Us Highway 15 501, Unit 1804, Aberdeen, NC 28315-2366 | 2013-07-30 |
| 1255614806 | Osama Afifi | Pharmacist | 24 Courtland Ln, Aberdeen, NJ 07747-2212 | 2011-09-21 |
| 1124327358 | Van Philip East Jr. | Pharmacist | 200 Highway 145 N, Aberdeen, MS 39730-2366 | 2011-03-28 |
| Find all providers in ABERDEEN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.