Mrs. Tara L Costa-Wallace, PHARMD
Pharmacist in Bristol, Rhode Island
1629224456- Practice location
- 580 Metacom Ave, Bristol, RI 02809-5182
- Phone
- 401-253-2723
- Fax
- 401-253-3980
- Last updated
- August 12, 2008
Tara Lee Costa-Wallace is a Pharmacist based in Bristol, RI. Tara Lee Costa-Wallace practices in Bristol, RI and has the professional credentials of PHARMD. The NPI Number for Tara Lee Costa-Wallace is 1629224456 and holds a License No. RPh03692 (RI). The current practice location address for Tara Lee Costa-Wallace is 580 Metacom Ave, Bristol, RI 02809-5182 and can be reached out via phone at 401-253-2723 and via fax at 401-253-3980.
Provider Profile Details
- NPI Number
- 1629224456
- Provider Name
- Tara Lee Costa-Wallace
- Credential
- PHARMD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 580 Metacom Ave, Bristol, RI 02809-5182
- Phone Number
- 401-253-2723
- Fax Number
- 401-253-3980
- Primary Taxonomy
- Pharmacist · 183500000X
- Sole Proprietor
- No
- Provider Enumeration Date
- August 12, 2008
- Last Update Date
- August 12, 2008
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 580 Metacom Ave
Bristol, RI 02809-5182 - City
- Bristol
- State
- Rhode Island
- Zip
- 02809-5182
- Phone Number
- 401-253-2723
- Fax Number
- 401-253-3980
Provider Business Mailing Address Details
- Address
- 580 Metacom Ave
Bristol, RI 02809-5182 - City
- Bristol
- State
- RI
- Zip
- 02809-5182
- Phone Number
- 401-253-2723
- Fax Number
- 401-253-3980
License Information
- License Number
- RPh03692
- License State
- RI
- Taxonomy
- Pharmacist · 183500000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Pharmacists near Bristol, RI
View all Pharmacists in Bristol →Frequently Asked Questions
What is the NPI number of Mrs. Tara L Costa-Wallace, PHARMD?
The NPI number of Mrs. Tara L Costa-Wallace, PHARMD is 1629224456. It was assigned on August 12, 2008 and is currently active in the NPPES registry.
What is the specialty of Mrs. Tara L Costa-Wallace, PHARMD?
Mrs. Tara L Costa-Wallace, PHARMD is registered under the primary taxonomy Pharmacist (code 183500000X), licensed in RI under license number RPh03692.
Where does Mrs. Tara L Costa-Wallace, PHARMD practice?
The practice location is 580 Metacom Ave, Bristol, RI 02809-5182. The office can be reached at 401-253-2723 (phone) or 401-253-3980 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1629224456 directly on the NPPES registry website.