Dwight D. Wallace, PHARMD
NPI 1104245620ActiveIndividual· Pharmacist· Aberdeen, ID
Pharmacist (PHARMD) in Aberdeen, Idaho, licensed in ID, with an NPI issued in April 2014.
Overview
| NPI | 1104245620 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHARMD |
| Sole proprietor | Yes |
| NPI issued | Apr 11, 2014 |
| Last updated in NPPES | Apr 11, 2014 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacist Primary | 183500000X | P4895 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|