National Provider Identifier Database

CAROL H WALLACE
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.


Contact Information

CAROL H WALLACE
1201 DINAH SHORE BOULEVARD
WINCHESTER, TN37398
Phone: 931-967-2777
Fax: 931-967-1264
Website:
Specialty Taxonomy Code
* Community/Retail Pharmacy 3336C0003X
Durable Medical Equipment & Medical Supplies 332B00000X
Long Term Care Pharmacy 3336L0003X
Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for CAROL H WALLACE

NPI Number 1962581702
Legal business name
LBN
CAROL H WALLACE
Authorized official CAROL WALLACE - (PIC OWNER)
Entity Organization
Organization subpart No
Enumeration date 11/03/2006
Last updated 08/14/2025 - About 10 months ago
Sole proprietor1 Not specified
Identifiers
  • TN License #: 0000001203
  • TN Medicaid: 1534061
  • Other: 2094785 PK

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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