Dr Larique Wallace, PHARMD - Pharmacist in Stamford, CT

Dr Larique Wallace, PHARMD is a Pharmacist based in Stamford, Connecticut. Dr Larique Wallace is licensed to practice in Connecticut (license number PCT.0015392) and her current practice location is 780 E Main St, Stamford, Connecticut. She can be reached at her office (for appointments etc.) via phone at (203) 353-9117.

NPI number for Dr Larique Wallace is 1114592714 and her current mailing address is 780 E Main St, Stamford, Connecticut. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1114592714.

Contact Information

Dr Larique Wallace, PHARMD
780 E Main St,
Stamford, CT 06902-3832
(203) 353-9117
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameDr Larique Wallace
GenderFemale
SpecialityPharmacist
Location780 E Main St, Stamford, Connecticut
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1114592714
  • Provider Enumeration Date: 05/25/2021
  • Last Update Date: 05/26/2021

Medical Identifiers

Medical identifiers for Dr Larique Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114592714NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
183500000XPharmacist PCT.0015392 (Connecticut)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Larique Wallace is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Larique Wallace, PHARMD
780 E Main St,
Stamford, CT 06902-3832

Ph: (203) 353-9117
Dr Larique Wallace, PHARMD
780 E Main St,
Stamford, CT 06902-3832

Ph: (203) 353-9117

Reviews and Comments


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