MRS. CAROL HENSHAW WALLACE (NPI# 1104107838) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104107838 |
| Entity Type | Individual |
| Full Name | MRS. CAROL HENSHAW WALLACE |
| Credential | PHARMACIST |
| Practice Address |
1201 Dinah Shore Boulevard Bennetts Pharmacy Winchester TN 37398 |
| Mailing Address |
Po Box 70 Bennetts Pharmacy Winchester TN 37398 |
| Practice Telephone | 9319672777 |
| Practice Fax Number | 9319671264 |
| Mailing Telephone | 9319672777 |
| Mailing Fax Number | 9319671264 |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2016-06-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 0000008424 | TN | Pharmacy Service Providers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 8424 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1534061 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083111728 | Carol Wallace | Licensed Practical Nurse | 1052 Archer Pl, Baldwin, NY 11510-3604 | 2018-04-10 |
| 1912022492 | Carol L Wallace | Marriage & Family Therapist | 2376 Maritime Dr, Suite 200, Elk Grove, CA 95758 | 2007-03-21 |
| 1780921643 | Carol S Wallace | Pharmacist | 2774 N Cobb Pkwy, Kennesaw, GA 30152-3469 | 2013-01-12 |
| 1497996623 | Carol Wallace | Social Worker | 1270 Doris Rd, Auburn Hills, MI 48326-2617 | 2009-03-18 |
| 1639348121 | Carol L. Wallace | Occupational Therapist | 7235 Whipple Ave Nw, North Canton, OH 44720-7137 | 2008-02-28 |
| 1790845006 | Carol Seeburger Wallace | Counselor | 220 W Ellsworth St, Midland, MI 48640-5180 | 2006-12-11 |
| 1639250996 | Carol A Wallace | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2006-10-17 |
| 1639272412 | Carol Ann Wallace | Health Maintenance Organization | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2006-09-06 |
| Street Address |
1201 DINAH SHORE BOULEVARD BENNETTS PHARMACY |
| City | WINCHESTER |
| State | TN |
| Zip Code | 37398 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962581702 | Carol H Wallace | Pharmacy | 1201 Dinah Shore Boulevard, Winchester, TN 37398 | 2006-11-03 |
| 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 | 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 |
|---|---|---|---|---|
| 1427659275 | Zachary Charles Woodley | Pharmacist | 151 Canterbury Ln, Winchester, VA 22603-4320 | 2020-11-06 |
| 1760082135 | Amanda Lee Hill | Pharmacist | 2350 S Pleasant Valley Rd, Winchester, VA 22601-7006 | 2020-10-27 |
| 1871193391 | Christy Mcquade | Pharmacist | 820 Bypass Rd, Winchester, KY 40391-1002 | 2020-10-26 |
| 1225635170 | Elizabeth Juergens | Pharmacist | 1438 Greystone Ter, Winchester, VA 22601-4444 | 2020-10-05 |
| 1841801610 | Glynis Muniz | Pharmacist | 456 Barley Ln, Winchester, VA 22602-2709 | 2020-08-13 |
| 1194351023 | Supannee Sandra Lertpaichaiyon | Pharmacist | 32627 Presidio Hills Ln, Winchester, CA 92596-8434 | 2020-03-23 |
| 1912472846 | Carolyn Louise Taylor | Pharmacist | 400 Gateway Dr, Winchester, VA 22603-5838 | 2018-10-08 |
| 1578044293 | Sandra Karyn Mccauley | Pharmacist | 727 Wades Mill Rd, Winchester, KY 40391-9632 | 2018-08-22 |
| 1780138644 | James Stewart | Pharmacist | 503 Duwamish Trl, Winchester, VA 22602-1711 | 2016-08-09 |
| 1528421922 | Derek Oliver | Pharmacist | 600 Fishel Rd, Winchester, VA 22602-3241 | 2016-04-01 |
| Find all providers in WINCHESTER | ||||
| City | WINCHESTER |
| Zip Code | 37398 |
Please comment or provide details below to improve the information on MRS. CAROL HENSHAW 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.