Wallace McLaurin Jr., PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

E-100331 Issued in MS

Practice address

4910 I 55 N
Jackson, MS 39211-5401

Phone

(601) 366-6554

NPI assigned

Jan 14, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

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.

• Kroger Limited Partnership I

  • Community/Retail Pharmacy
  • Jackson, MS
  • NPI 1295769073
  NPD
• Kroger Limited Partnership I

  • Community/Retail Pharmacy
  • Newport, KY
  • NPI 1104791078
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1831840420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 CEDAR TRCE",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392088611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 I 55 N",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115401",
            "telephone_number": "601-366-6554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAURIN",
        "first_name": "WALLACE",
        "name_suffix": "Jr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-14",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MS",
            "license": "E-100331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany McLaurin, COTA/L
• Erin McLaurin
• Jequetta Shureka Ilion McLaurin, FNP
• Monique McLaurin, FNP-BC
• Toy McLaurin, SLP
• Zoey McLaurin
• Josef McLean, MD
• Mark Andrew McLean, M.D.
• Vicky C McLean, M.D.
• Bernesha La'Sha McLemore, FNP

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Jackson, MS
• Providers in Jackson, MS by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.