Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Tara Lee Costa-Wallace, PHARMD

Individual provider Pharmacist · NPI 1629224456

Mrs. Tara Lee Costa-Wallace, PHARMD is a Pharmacist in Bristol, Rhode Island. Licensed in Rhode Island. Registered with an NPI since 2008.

Licensed in
RI
In the registry since
2008
What do these letters mean?
PHARMD — Doctor of Pharmacy
The professional degree required to practise as a pharmacist in the United States.

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Practice location Address checks out

580 Metacom Ave
Bristol, RI 02809-5182
Phone: (401) 253-2723
Fax: (401) 253-3980
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence RPH03692 (RI)

Record details

NPI number1629224456
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHARMD
Sole proprietorNo
NPI enumeratedAugust 12, 2008
Last updated in NPPESAugust 12, 2008

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