IndividualActive
Cory Wallace, PHARMD
NPI 1972103745 · Pharmacist · Broken Arrow, OK
Cory Wallace, PHARMD is a Pharmacist provider in Broken Arrow, OK (NPI 1972103745).
Provider details
- NPI number
- 1972103745
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Credential
- PHARMD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 14955 (OK)
Specialties & taxonomies
Pharmacy Service Providers
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 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
2301 W Kenosha St
Broken Arrow, OK 74012-8912
Phone: (918) 259-9136
Street-level locationGet directions
Mailing address
11005 S Joplin Pl
Tulsa, OK 74137-5023
Registry dates
- Enumerated
- 2020-10-29
- Last updated
- 2020-10-29
- Certified
- 2020-10-29
Frequently asked questions
- What is Cory Wallace's NPI number?
- Cory Wallace's National Provider Identifier (NPI) is 1972103745, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Cory Wallace's specialty?
- Cory Wallace is listed in the NPPES registry with a primary specialty of Pharmacist (Pharmacy Service Providers).
- Where is Cory Wallace located?
- Cory Wallace's practice location on file with NPPES is 2301 W Kenosha St, Broken Arrow, OK 74012-8912.
- What is Cory Wallace's phone number?
- The practice phone number listed in the NPPES registry for Cory Wallace is (918) 259-9136.
- Is Cory Wallace's NPI active?
- Yes — Cory Wallace's NPI (1972103745) is active in the NPPES registry as of the last update on 2020-10-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.