Thomas Danville Wallace, CPHT

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

37742 Issued in TN

Practice address

215 Dexter L Woods Memorial Blvd
Waynesboro, TN 38485-2416

Phone

(931) 722-5466

NPI assigned

Jul 17, 2012

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Duren Clinical Services, LLC

  • Community/Retail Pharmacy
  • Waynesboro, TN
  • NPI 1821054289
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 17, 2012.

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1265787147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 HIGHWAY 64 W",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384852355",
            "telephone_number": "931-722-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 DEXTER L WOODS MEMORIAL BLVD",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384852416",
            "telephone_number": "931-722-5466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "THOMAS",
        "middle_name": "DANVILLE",
        "credential": "CPHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "TN",
            "license": "37742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Total Therapy Center, LLC
• Harish Veeramachaneni, MD
• Voices of Savannah TN
• Volunteer Hospice Inc.
• Bruce Walker
• Rachel Walton
• Wayne Care Nursing Home
• Wayne County Assisted Living Facility
• Wayne County Nursing Home
• Wayne County Senior Citizens

• All providers in Waynesboro, TN
• Pharmacy Technician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.