Active NPI
Brent Wallace, R.PH.
- Pharmacist
- Columbus, OH
National Provider Identifier
1912321571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03122556
- Practice address
- 1661 Hilliard Rome Rd
Columbus, OH 43228-9485 - Phone
- (614) 771-9200
- Fax
- (614) 529-5165
- NPI assigned
- Feb 18, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03122556 | OH | Primary |
Addresses
Primary practice location
1661 Hilliard Rome Rd
Columbus, OH 43228-9485
Mailing address
1661 Hilliard Rome Rd
Columbus, OH 43228-9485
Phone (614) 771-9200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03122556 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aries Pharmacy LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392681600000",
"number": "1912321571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1661 HILLIARD ROME RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432289485",
"telephone_number": "614-771-9200",
"fax_number": "614-529-5165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1661 HILLIARD ROME RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432289485",
"telephone_number": "614-771-9200",
"fax_number": "614-529-5165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "BRENT",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-02-18",
"last_updated": "2014-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03122556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.