Active NPI
Juliet C Wallace, RPH
- Pharmacist
- Norman, OK
National Provider Identifier
1396950259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11375
- Practice address
- 901 N Porter Ave
Norman, OK 73071-6404 - Phone
- (405) 307-1940
- Fax
- (405) 307-1961
- NPI assigned
- May 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11375 | OK | Primary |
Addresses
Primary practice location
901 N Porter Ave
Norman, OK 73071-6404
Mailing address
2500 SW 83Rd St
Oklahoma City, OK 73159-5733
Phone (405) 686-1472
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11375 | OK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396950259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 SW 83RD ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731595733",
"telephone_number": "405-686-1472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 N PORTER AVE",
"city": "NORMAN",
"state": "OK",
"postal_code": "730716404",
"telephone_number": "405-307-1940",
"fax_number": "405-307-1961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "JULIET",
"middle_name": "C",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "11375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norman, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.