Tara Lee Costa-Wallace in Bristol - Pharmacist
Tara Lee Costa-Wallace - NPI 1629224456
Tara Lee Costa-Wallace is a Pharmacist in Bristol, Rhode Island. Tara Lee Costa-Wallace practices all healthcare services and medical treatments related to Pharmacist. The NPI Number for Tara Lee Costa-Wallace is 1629224456. The last update date is 2008-08-12.
Tara Lee Costa-Wallace's current location address is 580 Metacom Ave, Bristol, Rhode Island. You can contact this provider via phone number 4012532723 and fax number 4012533980. The mailing address for Tara Lee Costa-Wallace is 580 Metacom Ave, Bristol, Rhode Island. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tara Lee Costa-Wallace |
|---|---|
| Address | 580 Metacom Ave, Bristol, Rhode Island |
| Phone Number | 4012532723 |
| Fax Number | 4012533980 |
| Sole Proprietor | N |
| Credentials | PHARMD |
NPI Number Detail
| NPI Number | 1629224456 |
|---|---|
| Provider Enumeration Date | 2008-08-12 |
| Last Updated Date | 2008-08-12 |
Provider Mailing Address Detail
| Address | 580 Metacom Ave |
|---|---|
| City | Bristol |
| State | Rhode Island (RI) |
| Post Code | 28095182 |
| Phone Number | 4012532723 |
| Fax Number | 4012533980 |
Provider's Primary Taxonomy Detail
| Speciality | Pharmacist |
|---|---|
| Taxonomy | 183500000X |
| Licence No | RPH03692 |
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Definition: 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 m |
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Post Comment/ Review Below
What is the unique 10-digit identification code issued to Tara Lee Costa-Wallace by the Centers for Medicare & Medicaid Services?
The Tara Lee Costa-Wallace has been assigned the NPI (National Provider Identifier) 1629224456 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete physical address where Tara Lee Costa-Wallace is located?
The Tara Lee Costa-Wallace is situated at the following address: 580 Metacom Ave, Bristol, RI, 28095182.
What is Tara Lee Costa-Wallace's specialized field of practice, and what is the corresponding taxonomy classification code?
The Tara Lee Costa-Wallace's area of specialization is Pharmacist, and the corresponding taxonomy code that categorizes this field of practice is 183500000X.
On what date did Tara Lee Costa-Wallace receive its 1629224456 assignment from the Centers for Medicare & Medicaid Services?
The Tara Lee Costa-Wallace was assigned its 1629224456 on 2008-08-12, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Tara Lee Costa-Wallace last refreshed?
The information related to the Tara Lee Costa-Wallace, including its address, specialty, and other relevant details, was last updated on 2008-08-12.