MRS. TARA LEE COSTA-WALLACE


Address: 580 Metacom Ave, Bristol, RI 02809-5182
Phone: 4012532723

MRS. TARA LEE COSTA-WALLACE (NPI# 1629224456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629224456
Entity Type Individual
Full Name MRS. TARA LEE COSTA-WALLACE
Credential PHARMD
Practice Address 580 Metacom Ave
Bristol
RI 02809-5182
Practice Telephone 4012532723
Practice Fax Number 4012533980
Mailing Telephone 4012532723
Mailing Fax Number 4012533980
Enumeration Date 2008-08-12
Last Update Date 2008-08-12
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 183500000X Pharmacist RPH03692 RI Pharmacy Service Providers

Office Location

Street Address 580 METACOM AVE
City BRISTOL
State RI
Zip Code 02809-5182

Providers in the same location

NPI Name Taxonomy Address Enumeration
1417063603 Raffi Calikyan Internal Medicine 580 Metacom Ave, Bristol, RI 02809-5182 2006-08-22
1396268256 Walgreen Co Durable Medical Equipment & Medical Supplies 580 Metacom Ave, Bristol, RI 02809 2017-07-24
1639463938 Jennifer Lynn Ferreira Pharmacist 580 Metacom Ave, Bristol, RI 02809-5182 2011-06-03

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598246068 Maryann Bishop Physical Therapist 7 Creek Lane, Bristol, RI 02809 2018-08-23
1063913127 Melanie Hopper Koppelman Acupuncturist Harbor Integrative Health, LLC, 60 Poppasquash Road, Bristol, RI 02809 2018-02-23
1871011478 Ashley Hayes Pereira Occupational Therapist 31 Duffield Rd, Bristol, RI 02809 2017-09-03
1447792437 Marguerite Peruto Counselor 10 Wardwell Street, Studio #4, Bristol, RI 02809 2016-11-08
1174829873 Meghan Elizabeth Martorana Dietitian, Registered 685 Metacom Avenue, Bristol, RI 02809 2011-01-28
1881909794 Hoffmann Chiropractic Inc Chiropractor 450 Hope Street, Bristol, RI 02809 2010-08-16
1558555961 Michael James Allen Dentist 36 Bradford Street, Bristol, RI 02809 2007-08-29
1033309141 Melinda Mary Allaire Physical Therapist 2 Ruth Ave, Bristol, RI 02809 2007-07-26
1033240726 Emily Snow Delconte Dietitian, Registered 685 Metacom Ave, Bristol, RI 02809 2007-03-07
1881756203 Warren Dental Associates Inc Dentist 634 Main Street, Warren, RI 02809 2006-12-14
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Taxonomy Information

Taxonomy Code 183500000X
Grouping Pharmacy Service Providers
Classification Pharmacist

Taxonomy 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 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.
Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1073113791 Jamie Lester Pharmacist 21531 Market Ctr, Bristol, VA 24202-1808 2020-10-30
1699281113 Mythili Tarala Pharmacist 54 Bonnie Ct, Bristol, CT 06010-5994 2017-12-19
1750897666 Ray Mcclellan Massengill IIi Pharmacist 15767 Monticello Dr, Bristol, VA 24202-4113 2017-12-15
1740703065 Robert Christopher Isner Jr. Pharmacist 430 N Main St Ste A, Bristol, CT 06010-4117 2017-07-18
1033647755 Alyssa Emily Capuano Pharmacist 2 Betsy Dr, Bristol, RI 02809-4552 2017-05-24
1588103600 Elizabeth Anne Costello Pharmacist 747 Pine Street, Bristol, CT 06010 2017-02-22
1215324611 George Le Pharmacist 90 Maheu St, Bristol, CT 06010-3049 2015-04-23
1457783490 Amber Lynn Schreiner Pharmacist 1 Prince Ln, Bristol, VT 05443-1224 2013-08-01
1306282884 Penni Anne Cheatle Pharmacist 160 Indiana St, Bristol, CT 06010-9138 2013-05-10
1932451473 Katrina A Yoder Pharmacist 300 E Elkhart St, Bristol, IN 46507-9205 2012-10-08
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Competitor

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City BRISTOL
Zip Code 02809

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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