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DWIGHT D. WALLACE PHARMD
NPI 1104245620
Pharmacist in Aberdeen, ID

Active since April 11, 2014
44 S. MAIN ST, ABERDEEN, ID 83210(208) 397-4540 Get Directions Write a Review

NPPES record last updated: April 11, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dwight D. Wallace Pharmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DWIGHT D. WALLACE PHARMD (NPI 1104245620) is an individual pharmacist in Aberdeen, Idaho, licensed in Idaho (P4895) and active in the NPI registry since April 2014.

NPPES Registry Identity

NPI1104245620
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameDWIGHT D. WALLACECredential: PHARMD
Location Address44 S. MAIN STAberdeen, ID 83210
Mailing AddressPo Box 841Aberdeen, ID 83210-0841 · (208) 397-4540
Phone(208) 397-4540
Sole ProprietorYes
Enumeration DateApril 11, 2014
✔ NPI 1104245620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License✔ Licensed in ID · P4895
Definition
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.
44 S. MAIN ST, Aberdeen, ID 83210
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dwight Wallace's NPI number?

The NPI number for Dwight Wallace is 1104245620. It was assigned to this individual provider in the NPPES registry on April 11, 2014.

Where is Dwight Wallace located?

Dwight Wallace practices at 44 S. Main St, Aberdeen, ID 83210. The listed phone number is (208) 397-4540.

What is Dwight Wallace's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Dwight Wallace was last updated on April 11, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.