Mrs Tara Lee Costa-wallace, PHARMD - Pharmacist in Bristol, RI

Mrs Tara Lee Costa-wallace, PHARMD is a Pharmacist based in Bristol, Rhode Island. Mrs Tara Lee Costa-wallace is licensed to practice in Rhode Island (license number RPH03692) and her current practice location is 580 Metacom Ave, Bristol, Rhode Island. She can be reached at her office (for appointments etc.) via phone at (401) 253-2723.

NPI number for Mrs Tara Lee Costa-wallace is 1629224456 and her current mailing address is 580 Metacom Ave, Bristol, Rhode Island. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1629224456.

Contact Information

Mrs Tara Lee Costa-wallace, PHARMD
580 Metacom Ave,
Bristol, RI 02809-5182
(401) 253-2723
(401) 253-3980

Healthcare Provider's Profile

Full NameMrs Tara Lee Costa-wallace
GenderFemale
SpecialityPharmacist
Location580 Metacom Ave, Bristol, Rhode Island
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1629224456
  • Provider Enumeration Date: 08/12/2008
  • Last Update Date: 08/12/2008

Medical Identifiers

Medical identifiers for Mrs Tara Lee Costa-wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1629224456NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
183500000XPharmacist RPH03692 (Rhode Island)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Tara Lee Costa-wallace is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Tara Lee Costa-wallace, PHARMD
580 Metacom Ave,
Bristol, RI 02809-5182

Ph: (401) 253-2723
Mrs Tara Lee Costa-wallace, PHARMD
580 Metacom Ave,
Bristol, RI 02809-5182

Ph: (401) 253-2723

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Pharmacist in Bristol, RI

Dr. Alyssa Emily Capuano, PHARMD
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 2 Betsy Dr, Bristol, RI 02809
Phone: 401-525-6202    
Kenneth Olszewski,
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 400 Metacom Ave, Bristol, RI 02809
Phone: 401-253-2050    
Kathy Clemens,
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 7 3rd St, Bristol, RI 02809
Phone: 401-447-4354    
Rachel Elise Borges, B.S. PHARMD RPH
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 591 Metacom Ave, Bristol, RI 02809
Phone: 401-254-3903    
Elsiris Rosario, PHARMD
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 591 Metacom Ave, Bristol, RI 02809
Phone: 401-254-3903    Fax: 401-254-3907
Bethany Barone,
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 400 Metacom Ave, Bristol, RI 02809
Phone: 401-253-2050    
Susan Helen Levesque-degrazia, RPH
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 400 Metacom Ave, Bristol, RI 02809
Phone: 401-253-2050    Fax: 401-254-7413

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