MRS. JENNIFER LEIGH WALLACE (NPI# 1639404833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639404833 |
| Entity Type | Individual |
| Full Name | MRS. JENNIFER LEIGH WALLACE |
| Credential | PHARM D |
| Practice Address |
5230 Poplar Tent Rd Concord NC 28027-7757 |
| Practice Telephone | 7047841977 |
| Practice Fax Number | 7047841984 |
| Mailing Telephone | 7047841977 |
| Mailing Fax Number | 7047841984 |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2009-10-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 16942 | NC | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356968440 | Jennifer Wallace | Technician/Technologist | 2041 E 3rd Dr, Mesa, AZ 85204-1401 | 2020-07-06 |
| 1497249882 | Jennifer Laird Wallace | Licensed Practical Nurse | 4468 Duff Rd, Livingston, TX 77351-5627 | 2018-06-19 |
| 1124579602 | Jennifer Marie Wallace | Acupuncturist | 237 Avenida Del Norte, Redondo Beach, CA 90277-5702 | 2016-10-19 |
| 1174926984 | Jennifer Wallace | Specialist/Technologist | 806 Patton Chapel Trl, Hoover, AL 35226-2254 | 2014-10-07 |
| 1295083897 | Jennifer Wallace | Psychologist | 4226 Green Lake Rd, West Bloomfield, MI 48323-1139 | 2012-08-29 |
| 1669799086 | Jennifer Renea Wallace | Counselor | 3802 W University Blvd Apt 8104, Durant, OK 74701-3047 | 2010-04-24 |
| 1306035431 | Jennifer L Wallace | Physical Therapist | 3891 50th Ave S, Saint Petersburg, FL 33711-4811 | 2007-10-15 |
| 1316974058 | Jennifer Wallace | Speech-Language Pathologist | 1901 Century Blvd Ne Ste 20, Atlanta, GA 30345-3300 | 2006-06-27 |
| 1992766570 | Jennifer P Wallace | Specialist | 64400 E 26th Ct, Byers, CO 80103-8539 | 2006-03-31 |
| 1730154154 | Jennifer Lyn Wallace | Family Medicine | 1235 Se Division St, Suite 208, Portland, OR 97202-1099 | 2006-02-20 |
| Street Address |
5230 POPLAR TENT RD |
| City | CONCORD |
| State | NC |
| Zip Code | 28027-7757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922015924 | Walgreen Co | Pharmacy | 5230 Poplar Tent Rd, Concord, NC 28027-7757 | 2006-08-02 |
| 1922416254 | Danielle Lynn Nichols | Pharmacist | 5230 Poplar Tent Rd, Concord, NC 28027-7757 | 2014-07-30 |
| 1063747558 | Brandi Averett | Pharmacist | 5230 Poplar Tent Rd, Concord, NC 28027-7757 | 2009-10-16 |
| 1881927234 | Hai Nguyen | Pharmacist | 5230 Poplar Tent Rd, Concord, NC 28027-7757 | 2009-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023652252 | Medcare Transport of Nc | Non-emergency Medical Transport (VAN) | 7039 Northwinds Dr Nw, Unit C, Concord, NC 28027 | 2019-10-31 |
| 1538718770 | Carolyn Ann Broadnax | Technician | 3524 Cedar Springs Dr, Concord, NC 28027 | 2019-09-10 |
| 1447806575 | Claire-ann E Papp | Dentist | 8815 Christenbury Parkway, Suite 40, Concord, NC 28027 | 2019-08-14 |
| 1578120218 | Philip Osborn | Dentist | 5408 Nc-49, Harrisburg, NC 28027 | 2019-05-28 |
| 1639648306 | Kristen Morris Spell | Counselor | 195 Lower Cape Dr Sw Apt 107, Concord, NC 28027 | 2018-11-25 |
| 1568959625 | Laurie Ford | Counselor | 705 Samuel Adams Cir Sw, Concord, NC 28027 | 2018-04-15 |
| 1598278194 | Autumn Nobles | Specialist/Technologist | 10193 Falling Leaf Dr Nw, Concord, NC 28027 | 2017-11-06 |
| 1386192938 | Brundasudha Satti IIi | Physical Therapist | 379 Sutoforest Dr Nw, Concord, NC 28027 | 2016-09-12 |
| 1467809616 | Kathryn Teal Watts | Dentist | 5305345 Vining St Nw, #201, Concord, NC 28027 | 2016-05-18 |
| 1720443849 | Denette Carte | Health Educator | 9712 Ravenscroft Lane Nw, Concord, NC 28027 | 2015-12-16 |
| Find all providers in zip 28027 | ||||
| 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 |
|---|---|---|---|---|
| 1598376246 | Mazen A Seleem | Pharmacist | 1467 Balhan Dr Apt 106, Concord, CA 94521-3754 | 2020-08-14 |
| 1912538422 | Mohammed Youssef | Pharmacist | 1495 Balhan Dr Apt 208, Concord, CA 94521-3772 | 2020-02-03 |
| 1013477694 | Joseph Pirani | Pharmacist | 1 Granite Pl Ste N200, Concord, NH 03301-3274 | 2019-03-21 |
| 1386112548 | Andrew Barlow | Pharmacist | 631 Gable Oaks Ln Nw, Concord, NC 28027-5203 | 2018-11-06 |
| 1194293498 | Jeffrey Michael Cho | Pharmacist | 954 Rosehedge Ct, Concord, CA 94521-5453 | 2018-11-05 |
| 1720553951 | Lindsi Tillo | Pharmacist | 300 Poplar Station Cir Nw Apt 301, Concord, NC 28027-8363 | 2018-10-03 |
| 1144700261 | Susan Elizabeth Burpee | Pharmacist | 2837 Saint Joseph Dr, Concord, CA 94518-2154 | 2018-08-17 |
| 1205358678 | Eva Moen | Pharmacist | 19 Nathan Pratt Drive, Unit 308, Concord, MA 01742 | 2017-07-07 |
| 1215475421 | Hengameh Lavasanifar | Pharmacist | Jcb;131 Ornac Suite 200;, Mgh Cancer Center At Emerson Hospital, Concord, MA 01742 | 2017-02-08 |
| 1558806364 | Kirthana Beaulac | Pharmacist | 649 Cambridge Tpke, Concord, MA 01742-3726 | 2017-01-03 |
| Find all providers in CONCORD | ||||
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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.