Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1881977437 Deactivated / Inactive NPI Male Practitioner

Jerry Wallace , RPH

Pharmacist • Homestead, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jerry Wallace has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 21, 2011
NPI Deactivation Date December 16, 2019
Total Practice Duration ~8 Years of Practice (2011 – 2019)

Professional Overview & Biography Verified Profile Summary

Jerry Wallace, RPH was a registered Pharmacist practicing in Homestead, FL. Throughout an active medical career spanning 8 years, Jerry Wallace provided care at the practice location at 861 NE 8TH ST until profile deactivation on 2019-12-16.

Practice Location & Contact Primary Location

Practice Address

861 Ne 8th St

Homestead, FL 330305021

Telephone 3052450395
Fax 3052458678
Associated Practice Facility / Clinic
🏢 Walgreen Co Facility NPI 1275548414

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Homestead, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
89 Specialists

Practicing in Homestead, FL (19926 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License FL PS17029

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
NPI 1063175347
NPI 1063782506
NPI 1194007823
NPI 1639782774

Registered Pharmacist

NPI 1811485204

Doctor of Pharmacy (Pharm.D.)

NPI 1932810629

Registered Pharmacist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated December 16, 2019

Record deactivated on December 16, 2019

NPI Profile Active September 21, 2011

NPI status registered as active in NPPES database

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Updated Practice Location September 21, 2011

Registered at 861 NE 8TH ST, HOMESTEAD, FL 330305021 (Tel: 3052450395)

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Updated Business Mailing Address September 21, 2011

Registered at 176 BESSIE RD, TAVERNIER, FL 330702304 (Tel: 3053932369)

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Provider Name / Credentials Updated September 21, 2011

Recorded as JERRY WALLACE, RPH

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 21, 2011

Pharmacist (License #PS17029 in FL)

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Initial NPI Registration & Enumeration September 21, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1881977437
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 21, 2011
Last Update: September 21, 2011
Deactivation Date: December 16, 2019

Mailing Address

176 Bessie Rd

Tavernier, FL 330702304

Phone: 3053932369

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.