Cory Wallace, PHARMD
Cory Wallace is a Pharmacist provider (Pharmacist) practicing in Broken Arrow, OK, registered in the NPPES registry with NPI 1972103745 since 2020. The credential PHARMD stands for Doctor of Pharmacy.
✓ Active NPI ✓ Valid NPI checksum Sole proprietor
| NPI | 1972103745 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Cory Wallace |
| Credential | PHARMD |
| Sex | Male |
| Practice address | Broken Arrow, OK, 74012 |
| Phone | 9182599136 |
| Enumeration date | 2020-10-29 |
| Last updated in NPPES | 2020-10-29 |
Street address withheld — NPPES sole-proprietor addresses can be home addresses. See our data policy.
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 183500000X | Pharmacist | Primary | 14955 | OK |
PHARMD — Doctor of Pharmacy: A licensed pharmacist with a professional doctorate in pharmacy. About the PHARMD credential
Copy-ready billing details
Provider: Cory Wallace, PHARMD NPI: 1972103745 Taxonomy: 183500000X (Pharmacist) Address: Broken Arrow, OK, 74012
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1043237167 | Wal-Mart Stores East Lp | Organization | Community/Retail Pharmacy | Broken Arrow, OK |
| 1548309164 | Rediclinic LLC | Organization | Clinic/Center | Broken Arrow, OK |
| 1942820386 | Ashley Mcmahon | Individual | Pharmacist | Broken Arrow, OK |
| 1952902447 | Sandra Souvannachak | Individual | Pharmacist | Broken Arrow, OK |
| 1730765991 | Megan Thulin | Individual | Pharmacist | Broken Arrow, OK |
| 1033881693 | Sabrina Dunaway | Individual | Pharmacist | Broken Arrow, OK |
| 1902771173 | Wal-Mart Stores East , Lp | Organization | Optician | Broken Arrow, OK |
Verify this record
Cross-check NPI 1972103745 against the authoritative CMS record: view Cory Wallace on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-10-29.