Organization
J WALLACE LLC
Active
Organization
J WALLACE LLC
Active
Other names
GRANT COUNTY DRUGS WILLIAMSTOWN
Organization subpart
No
Provider details
NPI number
Authorized official
JASON WALLACE PHARMD, RPH (OWNER)
(859) 824-4239
Entity
Organization
Contact information
Practice address
302A BARNES RD, WILLIAMSTOWN, KY 41097-9483
(859) 824-4239
(859) 824-2110
Mailing address
302 BARNES RD, WILLIAMSTOWN, KY 41097-9483
(859) 824-4239
(859) 824-2110
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
P06979
KY
3336C0003X
Community/Retail Pharmacy
Primary
PO6979
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2029150
PK
—
05
—
54009139
—
KY
05
—
90011560
—
KY
Enumeration date
09/12/2006
Last updated
05/02/2025
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