WALLACE DRUG COMPANY INC (NPI# 1396874178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396874178 |
| Entity Type | Organization |
| Organization Name | WALLACE DRUG COMPANY INC |
| Other Organization Name | WALLACE DISCOUNT DRUGS |
| Practice Address |
520 N Magnolia St Laurel MS 39440-3559 |
| Practice Telephone | 6014281277 |
| Practice Fax Number | 6014281898 |
| Mailing Telephone | 6014284334 |
| Mailing Fax Number | 6014281898 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2016-08-10 |
| Authorized Official Name | JOSEPH ROBERTSON (OWNER/PIC) |
| Authorized Official Telephone | 6014281277 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
0162611 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 34908 | 05 | |
| PK | 2050522 | 01 |
| Other Name | Type Code |
|---|---|
| WALLACE DISCOUNT DRUGS | Doing Business As Name - Organization |
| Street Address |
520 N MAGNOLIA ST |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-3559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306323159 | Tender Loving Care Homecare LLC | Homemaker | 509 Central Ave Ste 224, Laurel, MS 39440 | 2018-07-24 |
| 1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
| 1215282991 | South Central Regional Medical Center | Clinic/Center | 525 Wayne Drive, Laurel, MS 39440 | 2012-07-18 |
| 1568721215 | Terry Ratcliff Perkins | Counselor | 5192 Hwy 11 North, Laurel, MS 39440 | 2012-05-15 |
| 1437453057 | Alexander Milne Home for Women | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 616 East 19th Street, Laurel, MS 39440 | 2010-12-23 |
| 1710135629 | Jeffrey R. Moffett | Nurse Practitioner | 3115 Audubon Dr, Laurel, MS 39440 | 2008-09-04 |
| 1003096785 | Family Health Center, Inc | Obstetrics & Gynecology | 103 S. 12th Avenue, Laurel, MS 39440 | 2007-11-09 |
| 1669672143 | Laurel Urology Clinic Pa | Urology | 304 S 10th Ave, Laurel, MS 39440 | 2007-07-23 |
| 1093912370 | Tanweer Hussain Majid | Surgery | 1007 Jefferson Street, Laurel, MS 39440 | 2007-06-29 |
| 1780889923 | Hattiesburg Eye Clinic, Pa | Ophthalmology | 1431 North 10th St, Suite 1, Laurel, MS 39440 | 2007-06-18 |
| Find all providers in zip 39440 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649763970 | Stacey Pariseault | Pharmacy | 8452 Early Bud Way, Laurel, MD 20723-1083 | 2018-06-12 |
| 1801205505 | Harris Teeter LLC | Pharmacy | 14702 Baltimore Ave, Laurel, MD 20707-4816 | 2014-08-06 |
| 1740537307 | Walgreen Co | Pharmacy | 600 Washington Blvd S, Laurel, MD 20707-4636 | 2012-08-13 |
| 1255474102 | Thirteenth Avenue Pharmacy | Pharmacy | 216 S 13th Ave, Laurel, MS 39440-4226 | 2007-02-14 |
| 1497855837 | Mississippi Cvs Pharmacy, L.L.C. | Pharmacy | 501 N 16th Ave, Laurel, MS 39440 | 2006-09-25 |
| 1821010570 | Maryland Cvs Pharmacy LLC | Pharmacy | 3343 Corridor Marketplace, Laurel, MD 20724-2378 | 2006-07-24 |
| 1609896513 | Walgreen Co. | Pharmacy | 30182 Sussex Hwy Unit 1, Laurel, DE 19956-3884 | 2006-07-20 |
| 1699708263 | Metcare Rx Laurel, LLC | Pharmacy | 7419 Van Dusen Rd, Laurel, MD 20707-6400 | 2006-07-08 |
| 1619428240 | Cvs | Pharmacy | 15100 Baltimore Ave, Laurel, MD 20707-4602 | 2016-10-19 |
| 1720531445 | Cvs | Pharmacy | 307 Se 4th St, Laurel, MT 59044-3324 | 2016-07-29 |
| Find all providers in LAUREL | ||||
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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.