Heath R Wallace, is a medicare enrolled "Dentist" provider in Weston, Ohio. His current practice location is
13160 Main Street, Weston, Ohio. You can reach out to his office (for appointments etc.) via phone at
(419) 669-2839.
Heath R Wallace is licensed to practice in Ohio (license number 30-022208) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1811010069.
Healthcare Provider's Profile
Full Name | Heath R Wallace |
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Gender | Male |
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Speciality | Dentist |
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Location | 13160 Main Street, Weston, Ohio |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1811010069
- Provider Enumeration Date: 04/10/2007
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 1658682521
- Enrollment ID: I20150618001403
Medical Identifiers
Medical identifiers for Heath R Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1811010069 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | 30-022208 (Ohio) | 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. Heath R Wallace is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Heath R Wallace, 13160 Main Street, Weston, OH 43569 Ph: (419) 669-2839 | Heath R Wallace, 13160 Main Street, Weston, OH 43569 Ph: (419) 669-2839 |
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