IndividualActive
Dwight Wallace, PHARMD
NPI 1104245620 · Pharmacist · Aberdeen, ID
Dwight Wallace, PHARMD is a Pharmacist provider in Aberdeen, ID (NPI 1104245620).
Provider details
- NPI number
- 1104245620
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Credential
- PHARMD
- Sex
- Male
- Sole proprietor
- Yes
- License
- P4895 (ID)
Specialties & taxonomies
Pharmacy Service Providers
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
44 S. Main St
Aberdeen, ID 83210
Phone: (208) 397-4540
Street-level locationGet directions
Mailing address
Po Box 841
Aberdeen, ID 83210-0841
Registry dates
- Enumerated
- 2014-04-11
- Last updated
- 2014-04-11
Frequently asked questions
- What is Dwight Wallace's NPI number?
- Dwight Wallace's National Provider Identifier (NPI) is 1104245620, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Dwight Wallace's specialty?
- Dwight Wallace is listed in the NPPES registry with a primary specialty of Pharmacist (Pharmacy Service Providers).
- Where is Dwight Wallace located?
- Dwight Wallace's practice location on file with NPPES is 44 S. Main St, Aberdeen, ID 83210.
- What is Dwight Wallace's phone number?
- The practice phone number listed in the NPPES registry for Dwight Wallace is (208) 397-4540.
- Is Dwight Wallace's NPI active?
- Yes — Dwight Wallace's NPI (1104245620) is active in the NPPES registry as of the last update on 2014-04-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.