Active NPI
Marlene Libby Wallis, RPH
- Pharmacist
- Victorville, CA
National Provider Identifier
1831625912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 32296
- Practice address
- 7081 SVL Box
Victorville, CA 92395-5108 - Phone
- (760) 617-3190
- NPI assigned
- May 10, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 32296 | CA | Primary |
Addresses
Primary practice location
7081 SVL Box
Victorville, CA 92395-5108
Mailing address
7081 SVL Box
Victorville, CA 92395-5108
Phone (760) 617-3190
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494374400000",
"number": "1831625912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7081 SVL BOX",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923955108",
"telephone_number": "760-617-3190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7081 SVL BOX",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923955108",
"telephone_number": "760-617-3190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLIS",
"first_name": "MARLENE",
"middle_name": "LIBBY",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-10",
"last_updated": "2017-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "32296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.