Mary M Stallworth, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

9205 Issued in AL

Practice address

1970 University Blvd S
Mobile, AL 36609-2924

Phone

(251) 666-6988

NPI assigned

Jun 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Mary M Ellis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wal-Mart Stores East LP

  • Community/Retail Pharmacy
  • Mobile, AL
  • NPI 1891712105
  NPD (past)
• Wal-Mart Stores East, LP

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871539692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 CLUB HOUSE RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366053931",
            "telephone_number": "251-476-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 UNIVERSITY BLVD S",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366092924",
            "telephone_number": "251-666-6988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLWORTH",
        "first_name": "MARY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "9205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "ELLIS",
            "middle_name": "M",
            "prefix": "MRS.",
            "credential": "RPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stalder Plastic Surgery Alabama LLC
• William Terry Stallings, M.D.
• Marnita Monique Stallworth Jones, AGPCNP
• Althelda Campbell Stallworth
• Bre'Yana Michelle Stallworth
• Patty Stallworth, CEO
• Tamela Stallworth
• Thomas Stallworth, ARNP
• Timara Keiana Stallworth
• Terri Stanley-Nolfe, MA, LMFT

• Pharmacist in Mobile, AL
• Providers in Mobile, AL by specialty
• Pharmacist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.