Dr. Larry Charles Wallis Llc is a
Optometrist based in Gloucester City, New Jersey. Dr. Larry Charles Wallis Llc is licensed to practice in * (Not Available) (license number ) and their current practice location is
14 N Broadway, Pob93, Gloucester City, New Jersey. It can be reached at their office (for appointments etc.) via phone at
(856) 456-3925.
NPI number for Dr. Larry Charles Wallis Llc is 1316382740 and their current mailing address is 14 N Broadway, Pob93, Gloucester City, New Jersey. Dr. Larry Charles Wallis Llc
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1316382740.
Healthcare Provider's Profile
Full Name | Dr. Larry Charles Wallis Llc |
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Type | Facility |
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Speciality | Optometrist |
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Location | 14 N Broadway, Gloucester City, New Jersey |
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Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
NPI Data:
- NPI Number: 1316382740
- Provider Enumeration Date: 04/29/2013
- Last Update Date: 04/29/2013
Medical Identifiers
Medical identifiers for Dr. Larry Charles Wallis Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1316382740 | NPI | - | NPPES |
1695401 | Medicaid | NJ | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
152W00000X | Optometrist | (* (Not Available)) | 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. Larry Charles Wallis Llc 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 Address | Practice Location Address |
Dr. Larry Charles Wallis Llc 14 N Broadway, Pob93, Gloucester City, NJ 08030-1507 Ph: (856) 456-3925 | Dr. Larry Charles Wallis Llc 14 N Broadway, Pob93, Gloucester City, NJ 08030-1507 Ph: (856) 456-3925 |
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