Organization
DALLAS EXPRESS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACOB TYLER WALLACE JR. (PRESIDENT)
(704) 922-3001
Entity
Organization
Contact information
Practice address
111A N HOFFMAN ST, DALLAS, NC 28034-1597
(704) 922-3001
(704) 922-0060
Mailing address
111A N HOFFMAN ST, DALLAS, NC 28034-1597
(704) 922-3001
(704) 922-0060
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
09048
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0366203
—
NC
01
—
3403451
NCPDP
NC
Enumeration date
04/06/2012
Last updated
09/21/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up