MR. DERRICK ALLAN WALL (NPI# 1124119342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124119342 |
| Entity Type | Individual |
| Full Name | MR. DERRICK ALLAN WALL |
| Credential | RPH |
| Practice Address |
239 Stuckey St Johnsonville SC 29555 |
| Mailing Address |
Po Box 947 Johnsonville SC 29555 |
| Practice Telephone | 8433866135 |
| Practice Fax Number | 8433801025 |
| Mailing Telephone | 8439330080 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2016-09-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 9429 | SC | Pharmacy Service Providers |
| Street Address |
239 STUCKEY ST |
| City | JOHNSONVILLE |
| State | SC |
| Zip Code | 29555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023109154 | April E Newell | Pharmacist | 239 Stuckey St, Johnsonville, SC 29555-6448 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518355080 | Carol A. Baker, Dmd, Pa | Clinic/Center | 144 E. Broadway St, Johnsonville, SC 29555 | 2015-01-06 |
| 1275871345 | Florence County School District Five | Skilled Nursing Facility | 156 East Marion Street, Johnsonville, SC 29555 | 2013-01-24 |
| 1295073559 | Florence School District Five | Local Education Agency (LEA) | 156 East Marion St., Johnsonville, SC 29555 | 2013-01-22 |
| 1073802633 | Johnsonville Adult Day Center | Non-emergency Medical Transport (VAN) | 351 S. Midway Highway, Johnsonville, SC 29555 | 2011-04-05 |
| 1235257734 | Johnsonville Rescue Squad and Ambulance Service Inc | Ambulance | 207 East Broadway St, Johnsonville, SC 29555 | 2007-03-26 |
| 1114006897 | Florence County School District Five | Clinic/Center | 237 S. Georgetown Hwy, Johnsonville, SC 29555 | 2006-11-03 |
| 1245321363 | Wall Drugs of Johnsonville, Inc. | Pharmacy | 239 Stuckey Street, Johnsonville, SC 29555 | 2006-09-27 |
| 1770682312 | Lower Florence County Hospital | Clinic/Center | 625 S Georgetown Hwy, Johnsonville, SC 29555 | 2006-09-21 |
| 1912001645 | Mcleod Physician Associates II | Clinic/Center | 355 South Georgetown Highway, Johnsonville, SC 29555 | 2006-09-12 |
| 1386688190 | Carol Anne Baker | Dentist | 144 East Broadway St, Johnsonville, SC 29555 | 2006-06-15 |
| Find all providers in zip 29555 | ||||
| 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 |
|---|---|---|---|---|
| 1558562918 | Chandace B Tanner | Pharmacist | 538 Myrtle Wood Ln, Johnsonville, SC 29555-6602 | 2007-05-31 |
| 1023109154 | April E Newell | Pharmacist | 239 Stuckey St, Johnsonville, SC 29555-6448 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083828 | David Ephriam Wilson V | Pharmacist | 4099 Red Bluff Rd, Loris, SC 29569-6238 | 2020-11-05 |
| 1609475458 | Douglas Hansford Netterville | Pharmacist | 248 Ivy Woods Ct, Fountain Inn, SC 29644-9256 | 2020-10-22 |
| 1497354385 | Caroline Gardner | Pharmacist | 1062 10th Ave, Aynor, SC 29511 | 2020-10-21 |
| 1972100246 | Meet Patel | Pharmacist | 210 Mcphail Farms Cir, Anderson, SC 29621-2579 | 2020-10-08 |
| 1780281170 | Hannah L Russell | Pharmacist | 2954 Eppington South Dr, Fort Mill, SC 29708-6949 | 2020-10-08 |
| 1235736133 | Renisha Rabara | Pharmacist | 2742 Disney Pl, Indian Land, SC 29707-5957 | 2020-10-04 |
| 1295342517 | Brandi Breunta Guinyard | Pharmacist | 805 Highway 9, Lancaster, SC 29720 | 2020-09-30 |
| 1003423377 | Terri Donofrio | Pharmacist | 5678 Captain Kidd Rd, Hollywood, SC 29449-6801 | 2020-09-30 |
| 1194331280 | Bryan Sabo | Pharmacist | 4361 Sc-24, Anderson, SC 29626 | 2020-09-23 |
| 1770198798 | Donnie Eric Ridings | Pharmacist | 471 Waterford Point Dr, Boiling Springs, SC 29316-7721 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSONVILLE |
| Zip Code | 29555 |
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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.