CAROL H WALLACE (NPI# 1962581702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962581702 |
| Entity Type | Organization |
| Organization Name | CAROL H WALLACE |
| Other Organization Name | BENNETT'S PHARMACY |
| Practice Address |
1201 Dinah Shore Boulevard Winchester TN 37398 |
| Mailing Address |
Po Box 70 1201 Dinah Shore Boulevard Winchester TN 37398 |
| Practice Telephone | 9319672777 |
| Practice Fax Number | 9319671264 |
| Mailing Telephone | 9319672777 |
| Mailing Fax Number | 9319671264 |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2016-10-31 |
| Authorized Official Name | CAROL WALLACE (PIC OWNER) |
| Authorized Official Telephone | 9319672777 |
| Authorized Official Credential | PHARM.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
0000001203 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1534061 | 05 | |
| PK | 2094785 | 01 |
| Other Name | Type Code |
|---|---|
| BENNETT'S PHARMACY | Doing Business As Name - Organization |
| Street Address |
1201 DINAH SHORE BOULEVARD |
| City | WINCHESTER |
| State | TN |
| Zip Code | 37398 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104107838 | Carol Henshaw Wallace | Pharmacist | 1201 Dinah Shore Boulevard, Bennetts Pharmacy, Winchester, TN 37398 | 2011-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235738170 | Results-ast Jv, LLC | Physical Therapist | 2030 Cowan Highway, Suite 1, Winchester, TN 37398 | 2020-10-21 |
| 1902239759 | Ann C Richardson | Pharmacist | 1201 Dinah Shore Blvd, Winchester, TN 37398 | 2013-08-15 |
| 1851734230 | Gina Renee Jacobs | Ambulance | 305 N College St., Winchester, TN 37398 | 2013-04-16 |
| 1083895205 | Jill Kay Stokes | Occupational Therapy Assistant | 463 Dripping Springs Road, Winchester, TN 37398 | 2007-11-15 |
| 1457459562 | Karen A Tidmore | Family Medicine | 1811 Sharp Springs Rd, Winchester, TN 37398 | 2006-09-20 |
| 1356385967 | Sherry Lee | Nurse Practitioner | 1211 Dinah Shore Blvd, Winchester, TN 37398 | 2006-06-15 |
| 1912985425 | Caresouth Hha Holdings of Winchester LLC | Durable Medical Equipment & Medical Supplies | 2068 Cowan Hwy, Winchester, TN 37398 | 2006-01-04 |
| 1215372768 | Clive Anderson Wasson | Surgery | 83 Memorial Dr, Winchester, TN 37398 | 2013-05-09 |
| 1326322967 | John Anthony O'driscoll Jr. | Physical Therapist | 2030 Cowan Hwy Ste 1, Winchester, TN 37398 | 2011-09-30 |
| 1013159169 | Wanda Lynn Spencer | Counselor | 100 1st Ave Sw, Suite 202 C, Winchester, TN 37398 | 2009-04-02 |
| Find all providers in zip 37398 | ||||
| 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] |
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| 1790320018 | Hometown Pharmacy of Winchester, Pllc | Pharmacy | 200 Codella Dr Ste C, Winchester, KY 40391-7101 | 2019-11-11 |
| 1396252375 | Claudia Firestone Stiebel | Pharmacy | 1110 Breckinridge Ln, Winchester, VA 22601-6709 | 2017-12-29 |
| 1912421272 | Corner Drug LLC | Pharmacy | 4 N Highland St Ste B, Winchester, KY 40391-2024 | 2017-07-28 |
| 1316047624 | Garfield Beach Cvs LLC | Pharmacy | 30736 Benton Rd, Winchester, CA 92596 | 2006-09-25 |
| 1144329442 | Cvs Pharmacy Inc | Pharmacy | 539 Main St # 545, Winchester, MA 01890-2914 | 2006-09-22 |
| 1073616702 | Virginia Cvs Pharmacy L L C | Pharmacy | 2207 Valley Ave, Winchester, VA 22601-2755 | 2006-09-07 |
| 1336242858 | Virginia Cvs Pharmacy LLC | Pharmacy | 840 Berryville Ave, Winchester, VA 22601-5914 | 2006-09-07 |
| 1336242080 | Virginia Cvs Pharmacy L L C | Pharmacy | 1379 N Frederick Pike, Winchester, VA 22603-8693 | 2006-09-07 |
| 1790895324 | Costco Wholesale Corporation | Pharmacy | 251 Front Royal Pike, Winchester, VA 22602-7319 | 2006-08-30 |
| 1053335638 | Gaunts Drug Store | Pharmacy | 1 Valley Ave., Winchester, VA 22601 | 2006-07-27 |
| Find all providers in WINCHESTER | ||||
| City | WINCHESTER |
| Zip Code | 37398 |
Please comment or provide details below to improve the information on CAROL H WALLACE.
| 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.