Dwight D Wallace, PHARMD in Aberdeen, ID - Pharmacist

Dwight D Wallace, PHARMD is a Pharmacist based in Aberdeen, Idaho. Dwight D Wallace is licensed to practice in Idaho (license number P4895) and his current practice location is 44 S. Main St, Aberdeen, Idaho. He can be reached at his office (for appointments etc.) via phone at (208) 397-4540.

NPI number for Dwight D Wallace is 1104245620 and his current mailing address is Po Box 841, Aberdeen, Idaho. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1104245620.

Contact Information

	Dwight D Wallace, PHARMD
	44 S. Main St, Aberdeen, ID 83210
	(208) 397-4540
	Not Available

Healthcare Provider's Profile

Full Name	Dwight D Wallace
Gender	Male
Speciality	Pharmacist
Location	44 S. Main St, Aberdeen, Idaho
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1104245620
Provider Enumeration Date: 04/11/2014
Last Update Date: 04/11/2014

Medical Identifiers

Medical identifiers for Dwight D Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104245620	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
183500000X	Pharmacist	P4895 (Idaho)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dwight D Wallace is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dwight D Wallace, PHARMD Po Box 841, Aberdeen, ID 83210-0841 Ph: (208) 397-4540	Dwight D Wallace, PHARMD 44 S. Main St, Aberdeen, ID 83210 Ph: (208) 397-4540

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Dwight D Wallace, PHARMD - Pharmacist in Aberdeen, ID