Wallace, Jacob Tyler
Wallace, Jacob Tyler is an sole proprietor health care provider with primary practice located at 201 W Marion St Ste 100 , Shelby NC 28150-5094. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Wallace, Jacob Tyler can be contacted via phone (980) 552-4402.Contact Information
Primary practice address
201 W Marion St Ste 100
Shelby NC 28150-5094
Phone: (980) 552-4402
Fax: (704) 831-8118
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 21863 | North Carolina |
Profile Details
| NPI number | 1427338169 |
|---|---|
| LBN Legal business name | Wallace, Jacob Tyler |
| Credentials | PHARMD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 25th, 2011 |
| Last updated | Feb 2nd, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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