Organization
CAROL H WALLACE
Active
Other names
BENNETT'S PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL WALLACE PHARM.D (PIC OWNER)
(931) 967-2777
Entity
Organization
Contact information
Practice address
1201 DINAH SHORE BOULEVARD, WINCHESTER, TN 37398
(931) 967-2777
(931) 967-1264
Mailing address
PO BOX 70, 1201 DINAH SHORE BOULEVARD, WINCHESTER, TN 37398
(931) 967-2777
(931) 967-1264
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0000001203
TN
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1534061
—
TN
01
—
2094785
PK
—
Enumeration date
11/03/2006
Last updated
08/14/2025
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