Wallis Enterprises Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH00001546 Issued in NM

Legal business name

WALLIS ENTERPRISES INC

Doing business as

Las Cruces Rexall

Practice address

2140 N Main St
Las Cruces, NM 88001-1129

Phone

(505) 524-2863

Fax

(505) 525-3192

NPI assigned

Dec 5, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Scott W Wallis, R. PH.

Title

President

Phone

(505) 524-2863

Specialties & licenses 1

Addresses

Other names 1

• Las Cruces Rexall Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1467510891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 N MAIN ST",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880011129",
            "telephone_number": "505-524-2863",
            "fax_number": "505-525-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 N MAIN ST",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880011129",
            "telephone_number": "505-524-2863",
            "fax_number": "505-525-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLIS ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "WALLIS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-524-2863",
        "authorized_official_credential": "R. PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NM",
            "license": "PH00001546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Las Cruces Rexall",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lura Wallace, LISW
• Michael Jon Wallace, CPSW
• Makayla Wallender
• Michelle Waller, RBT
• Wendi Cheree Wallin, DC
• Jared S. Wallis, DDS
• Leah Wallis
• Jedediah Walls, LMHC, ATR-P
• Georgine Walsh, CF-SLP
• Stephanie Walterman

• Community/Retail Pharmacy in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Community/Retail Pharmacy in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.