Shanise Wallace, - Pharmacist in Kenosha, WI

Shanise Wallace, is a Pharmacist based in Kenosha, Wisconsin. Shanise Wallace is licensed to practice in Wisconsin (license number 17696-40) and her current practice location is 3710 57th Ave, Kenosha, Wisconsin. She can be reached at her office (for appointments etc.) via phone at (262) 652-1474.

NPI number for Shanise Wallace is 1114552445 and her current mailing address is 3710 57th Ave, Kenosha, Wisconsin. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1114552445.

Contact Information

Shanise Wallace,
3710 57th Ave,
Kenosha, WI 53144-4820
(262) 652-1474
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameShanise Wallace
GenderFemale
SpecialityPharmacist
Location3710 57th Ave, Kenosha, Wisconsin
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1114552445
  • Provider Enumeration Date: 03/06/2020
  • Last Update Date: 03/06/2020

Medical Identifiers

Medical identifiers for Shanise Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114552445NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
183500000XPharmacist 17696-40 (Wisconsin)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. Shanise 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
Shanise Wallace,
3710 57th Ave,
Kenosha, WI 53144-4820

Ph: () -
Shanise Wallace,
3710 57th Ave,
Kenosha, WI 53144-4820

Ph: (262) 652-1474

Reviews and Comments


Pharmacist in Kenosha, WI

Mitchell Robak, PHARMD
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 2207 80th St, Kenosha, WI 53143
Phone: 262-658-3731    
Carolyn Schiller,
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 3820 52nd St, Kenosha, WI 53144
Phone: 262-652-9665    Fax: 262-652-0896
Daniel Lupi, PHARMD
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 3805 80th St, Kenosha, WI 53142
Phone: 262-694-0750    
Dr. Danielle T Kroll, PHARMD
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 9916 75th St Ste 103, Kenosha, WI 53142
Phone: 262-925-0201    Fax: 262-925-8373
Daisy Nichols,
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 7701 Green Bay Rd, Kenosha, WI 53142
Phone: 262-612-1610    
Aaron Buresh, PHARMD
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 3710 57th Ave, Kenosha, WI 53144
Phone: 262-652-1474    
Lisa Mutchler, PHARMD.
Pharmacist
Medicare: Not Enrolled in Medicare
Practice Location: 7525 Sheridan Rd, Kenosha, WI 53143
Phone: 262-652-2396    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.