MR. ROBERT WALLACE (NPI# 1750443024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750443024 |
| Entity Type | Individual |
| Full Name | MR. ROBERT WALLACE |
| Practice Address |
12421 W Denton Ave Litchfield Park AZ 85340-3435 |
| Practice Telephone | 6235359788 |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | INTERN -- 6699 | AZ | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316430176 | Robert E Wallace | Case Manager/Care Coordinator | 283 Old Colliers Way, Weirton, WV 26062-4073 | 2018-06-07 |
| 1801337134 | Robert William Wallace II | Student in an Organized Health Care Education/Training Program | 204 N Silver Maple Dr, Slidell, LA 70458-5483 | 2017-03-20 |
| 1780015610 | Robert G. Wallace | Radiology | 1130 Goat Rock Road, Fortson, GA 31808 | 2013-12-03 |
| 1972947257 | Robert William Wallace | Registered Nurse | 40 Ridge Dr, West Hurley, NY 12491-5627 | 2013-04-17 |
| 1487991683 | Robert J Wallace | Acupuncturist | 1619 W Montrose, Chicago Holistic Medicine, Chicago, IL 60613 | 2013-01-08 |
| 1154582773 | Robert Lee Wallace | Counselor | 110 S Hancock St, Rockingham, NC 28379-3675 | 2008-06-17 |
| 1649484635 | Robert Jay Wallace | Obstetrics & Gynecology | 6250 Alfred Harrell Hwy, Bakersfield, CA 93308-9654 | 2007-05-09 |
| 1023132644 | Robert S Wallace | Chiropractor | 7 Centre Dr, Suite 10, Monroe, NJ 08831-1565 | 2007-03-19 |
| 1922113174 | Robert Vernon Wallace | Family Medicine | 400 Lee Blvd, Lehigh Acres, FL 33936-4923 | 2006-08-20 |
| 1134133200 | Robert Duncan Wallace | Psychiatry & Neurology | 2972 Devonshire Cir, Salt Lake City, UT 84108-2526 | 2006-07-27 |
| Street Address |
12421 W DENTON AVE |
| City | LITCHFIELD PARK |
| State | AZ |
| Zip Code | 85340-3435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104393826 | Nelson J. Mar Dds PC | Dentist | 5220 N. Dysart Rd #144, Litchfield Park, AZ 85340 | 2018-10-31 |
| 1841771920 | Harmony Health and Wellness Foundation | Clinic/Center | 5220 N Dysart Rd Building C, Litchfield Park, AZ 85340 | 2018-08-27 |
| 1346726676 | Vista Counseling and Consulting | Community/Behavioral Health | 501 East Plaza Circle, Suite 3, Litchfield Park, AZ 85340 | 2018-07-19 |
| 1982194148 | Melinda Michelle Melvin | Registered Nurse | 255 E Wigwam Blvd., Litchfield Park, AZ 85340 | 2018-05-14 |
| 1952803652 | Comfort Care Providers, LLC. | Physiological Laboratory | 555 E Plaza Cir Dr Ste C, Litchfield Park, AZ 85340 | 2018-03-08 |
| 1992204614 | Angelo J Maisano | Occupational Therapy Assistant | 4870 N Litchfield Road Suite #101, Litchfield Park, AZ 85340 | 2018-02-08 |
| 1114438645 | Lori Ann Compiani | Licensed Practical Nurse | 272 E. Sagebrush St., Litchfield Park, AZ 85340 | 2017-10-24 |
| 1265972947 | Christina Martinez | Specialist/Technologist | 4870 North Litchfield Rd #101, Litchfield Park, AZ 85340 | 2017-03-01 |
| 1457802019 | Urgent Care Centers of Arizona, LLC | Clinic/Center | 13840 W. Camelback Rd, Suite 10, Litchfield Park, AZ 85340 | 2016-10-19 |
| 1336698034 | Judy Tooley | Licensed Practical Nurse | 255 E Wigwam Blvd, Litchfield Park, AZ 85340 | 2016-09-23 |
| Find all providers in zip 85340 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225353261 | John-paul Huston | Pharmacist | 13331 W Romain Ct, Litchfield Park, AZ 85340-5376 | 2010-04-01 |
| 1134729635 | Lucy N Mambo | Pharmacist | 13014 W Camelback Rd, Litchfield Park, AZ 85340 | 2020-10-26 |
| 1912525080 | Thao Nguyen | Pharmacist | 13014 W Camelback Rd, Litchfield Park, AZ 85340-9401 | 2020-07-06 |
| 1346886520 | Haroutune H Alahaydoian | Pharmacist | 13014 W Camelback Rd, Litchfield Park, AZ 85340-9401 | 2019-11-21 |
| 1174178149 | Justin Hill | Pharmacist | 4890 N Litchfield Rd, Litchfield Park, AZ 85340-5015 | 2019-08-07 |
| 1699243329 | Joseph King | Pharmacist | 4890 N Litchfield Rd, Litchfield Park, AZ 85340-5015 | 2018-11-12 |
| 1770061327 | David Ross | Pharmacist | 4890 N Litchfield Rd, Litchfield Park, AZ 85340-5015 | 2018-08-04 |
| 1710481940 | Frances Chukwuechezonam Unomah | Pharmacist | 4890 N Litchfield Rd, Litchfield Park, AZ 85340-5015 | 2018-03-21 |
| 1700274461 | Joseph Tran | Pharmacist | 13014 W Camelback Rd, Litchfield Park, AZ 85340-9401 | 2015-01-05 |
| 1831594704 | Etukeren Etukeren | Pharmacist | 13014 W Camelback Rd, Litchfield Park, AZ 85340-9401 | 2014-11-04 |
| Find all providers in LITCHFIELD PARK | ||||
| City | LITCHFIELD PARK |
| Zip Code | 85340 |
Please comment or provide details below to improve the information on MR. ROBERT WALLACE.
| 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.