CORY WALLACE PHARMD
NPI 1972103745
Pharmacist in Broken Arrow, OK

Active since October 29, 2020
2301 W KENOSHA ST, BROKEN ARROW, OK 74012(918) 259-9136 Get Directions Write a Review

NPPES record last updated: October 29, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Cory Wallace Pharmd NPPES

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

CORY WALLACE PHARMD (NPI 1972103745) is an individual pharmacist in Broken Arrow, Oklahoma, licensed in Oklahoma (14955) and active in the NPI registry since October 2020.

NPPES Registry Identity

NPI1972103745
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameCORY WALLACECredential: PHARMD
Location Address2301 W KENOSHA STBroken Arrow, OK 74012-8912
Mailing Address11005 S Joplin PlTulsa, OK 74137-5023
Sole ProprietorYes
Enumeration DateOctober 29, 2020
NPPES CertifiedOctober 29, 2020
NPI 1972103745 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in OK · 14955
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.
2301 W KENOSHA ST, Broken Arrow, OK 74012

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
2301 W KENOSHA ST
BROKEN ARROW, OK 74012
Pharmacy (Community/Retail Pharmacy)
2301 W KENOSHA ST
BROKEN ARROW, OK 74012
Clinic/Center
2301 W KENOSHA ST
BROKEN ARROW, OK 74012
Pharmacist
2301 W KENOSHA ST
BROKEN ARROW, OK 74012
Technician/Technologist (Optician)
2301 W KENOSHA ST
BROKEN ARROW, OK 74012
Pharmacist
2301 W KENOSHA ST
BROKEN ARROW, OK 74012
Pharmacist
2301 W KENOSHA ST
BROKEN ARROW, OK 74012

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 Cory Wallace's NPI number?

The NPI number for Cory Wallace is 1972103745. It was assigned to this individual provider in the NPPES registry on October 29, 2020.

Where is Cory Wallace located?

Cory Wallace practices at 2301 W Kenosha St, Broken Arrow, OK 74012. The listed phone number is (918) 259-9136.

What is Cory 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 Cory Wallace was last updated on October 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.