J WALLACE LLC (NPI# 1184728149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184728149 |
| Entity Type | Organization |
| Organization Name | J WALLACE LLC |
| Other Organization Name | GRANT COUNTY DRUGS WILLIAMSTOWN |
| Practice Address |
302 Barnes Rd Williamstown KY 41097-9483 |
| Practice Telephone | 8598244239 |
| Practice Fax Number | 8598242110 |
| Mailing Telephone | 8598244239 |
| Mailing Fax Number | 8598242110 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2016-02-15 |
| Authorized Official Name | JASON WALLACE (OWNER) |
| Authorized Official Telephone | 8598244239 |
| Authorized Official Credential | PHARMD, RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
P06979 | KY | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PO6979 | KY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2029150 | 01 | |
| KY | 54009139 | 05 |
| Other Name | Type Code |
|---|---|
| GRANT COUNTY DRUGS WILLIAMSTOWN | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | J WALLACE LLC | 637 State St, Ogdensburg, Ny 13669 |
| Street Address |
302 BARNES RD |
| City | WILLIAMSTOWN |
| State | KY |
| Zip Code | 41097-9483 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982974044 | Brenda Jean Snow | Occupational Therapy Assistant | 201 Kimberly Lane, Williamstown, KY 41097 | 2012-01-06 |
| 1215121272 | Air Evac Ems Inc. | Ambulance | 110 Mercedes Dr, Williamstown, KY 41097 | 2007-09-04 |
| 1184782690 | Foot Specialists of Greater Cincinnati | Podiatrist | 238 Barnes Road, St Elizabeth Grant County, Williamstown, KY 41097 | 2006-12-05 |
| 1972549202 | Michelle L Napier | Nurse Practitioner | 300 Helton Street, Williamstown, KY 41097 | 2006-06-22 |
| 1902892136 | Robert William Noelker | Psychologist | 1406 N Main Street, Williamstown, KY 41097 | 2005-09-22 |
| 1447598586 | Orthocincy | Orthopaedic Surgery | 238 Barnes Rd, Williamstown, KY 41097 | 2013-01-24 |
| 1174780647 | St Elizabeth Medical Center, Inc | Clinical Medical Laboratory | 238 Barnes Rd, Williamstown, KY 41097 | 2008-05-21 |
| 1902092208 | Midlands Behavioral Medicine | Psychologist | 1406 N Main Street, Williamstown, KY 41097 | 2007-09-20 |
| 1386727907 | Mindy Craft | Psychologist | 308 Barnes Pike, Williamstown, KY 41097 | 2006-10-24 |
| 1225063837 | Nicole Writh | Technician, Other | 308 Barnes Pike, Williamstown, KY 41097 | 2006-07-11 |
| Find all providers in zip 41097 | ||||
| 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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|---|---|---|---|---|
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| 1598848822 | New Jersey Cvs Pharmacy LLC | Pharmacy | 1239 S Black Horse Pike, Williamstown, NJ 08094-1925 | 2006-10-23 |
| 1154413748 | New Jersey Cvs Pharmacy LLC | Pharmacy | 2305 Glassboro Cross Keys Rd, Williamstown, NJ 08094-8905 | 2006-09-29 |
| 1679688451 | Berat Corporation | Pharmacy | 100 S Black Horse Pike, Williamstown, NJ 08094-1560 | 2006-08-20 |
| 1275548166 | Walgreen Co | Pharmacy | 13 N Black Horse Pike, Williamstown, NJ 08094 | 2006-07-29 |
| 1982224994 | Berkshire Apothecary Inc. | Pharmacy | 72 Spring St, Williamstown, MA 01267-2853 | 2020-04-20 |
| 1659896710 | Walgreen Co | Pharmacy | 212 Main St, Williamstown, MA 01267-2641 | 2017-08-10 |
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|---|---|---|---|---|
| 1306445259 | Middletown Pharmacist Group | Pharmacy | 11601 Shelbyville Rd Ste B, Louisville, KY 40243-1309 | 2020-10-21 |
| 1144828724 | Pharmacy Care Center | Pharmacy | 10616 South Ky Hwy 15, Scuddy, KY 41760 | 2020-10-15 |
| 1497361208 | Kerry Hettinger | Pharmacy | 1114 Schiller Ave, Louisville, KY 40204-1946 | 2020-09-17 |
| 1114539822 | B&b Pharmacy, Pllc | Pharmacy | 126 Shadowmeade Lane, Unit 2, Mount Washington, KY 40047 | 2020-08-24 |
| 1376161588 | Arh Mary Breckinridge Health Services, Inc. | Pharmacy | 3504 West Cumberland Ave, Middlesboro, KY 40965-2612 | 2020-07-14 |
| 1073139531 | Cornerstone Care Associates | Pharmacy | 1509 1/2 Lexington Rd Ste 2, Richmond, KY 40475-1060 | 2020-06-21 |
| 1912523614 | Oldham Pharmacist Group | Pharmacy | 1000 Cherrywood Pl Ste 100, La Grange, KY 40031-8927 | 2020-06-18 |
| 1578187209 | St. Elizabeth Medical Center, Inc. | Pharmacy | 1 Medical Village Dr., Edgewood, KY 41017 | 2020-05-28 |
| 1922629997 | Classic Specialty Pharmacy Pllc | Pharmacy | 3582 Springhurst Blvd, Louisville, KY 40241-4141 | 2020-05-01 |
| 1346860095 | Dupont Pharmacy, LLC | Pharmacy | 3924 S Dupont Sq Ste D, Louisville, KY 40207-5912 | 2020-04-23 |
| Find all providers with the same taxonomy | ||||
| City | WILLIAMSTOWN |
| Zip Code | 41097 |
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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.