Takova Wallace, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

17723 Issued in AL

Practice address

215 Perry Hill Rd
Montgomery, AL 36109-3725

Phone

(334) 272-4670

NPI assigned

Jul 10, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1851707889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 STONE PARK BLVD APT 2313",
            "city": "PIKE ROAD",
            "state": "AL",
            "postal_code": "360643023",
            "telephone_number": "256-322-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 PERRY HILL RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361093725",
            "telephone_number": "334-272-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "TAKOVA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-10",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "17723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roszell Nicole Walker
• Leigh A Wallace, SP
• Maci Wallace, PT
• Marilynn R. Wallace, PHARM.D.
• Mathew Cary Wallace, M.D.
• Gregory Allen Waller, M.D.
• Jacqueline Rae Waller, PHARMD
• Wallers Transport Services LLC
• Cooper Walley, RN
• Lawrence A Wallin, MD

• All providers in Montgomery, AL
• Pharmacist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; 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.