Wallace Health, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WALLACE HEALTH, INC.

Practice address

1808 Beverley Rd Apt C4
Brooklyn, NY 11226-8601

Phone

(631) 805-1562

NPI assigned

Feb 1, 2019

Last updated

Feb 1, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Timothy Wallace

Title

Owner

Phone

(631) 805-1562

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548979200000",
    "number": "1386109585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 BEVERLEY RD APT C4",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112268601",
            "telephone_number": "631-805-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 BEVERLEY RD APT C4",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112268601",
            "telephone_number": "631-805-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLACE HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-01",
        "last_updated": "2019-02-01",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-805-1562"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Lucas Wall
• Dina Wall, SPECIAL ED
• Ian Wall, D.O.
• Wallabout Pharmacy Inc (Remedies Pharmacy)
• Wallabout Pharmacy Inc (Remedies Pharmacy)
• Georgia Wallace-Scott
• Dorian James Wallace, MT-BC
• Elese Marlene Wallace, LPN
• Giselle Fourier Wallace, DDS
• Gloria Elizabeeth Wallace Jr., RN

• Durable Medical Equipment & Medical Supplies in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.