Provider Demographics
NPI:1053927053
Name:WHITE'S PHARMACY, INC.
Entity type:Organization
Organization Name:WHITE'S PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMD/SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-928-4421
Mailing Address - Street 1:301 FIFTH AVE W
Mailing Address - Street 2:
Mailing Address - City:WIGGINS
Mailing Address - State:MS
Mailing Address - Zip Code:39577-2204
Mailing Address - Country:US
Mailing Address - Phone:016-928-4421
Mailing Address - Fax:601-928-3967
Practice Address - Street 1:301 FIFTH AVE W
Practice Address - Street 2:
Practice Address - City:WIGGINS
Practice Address - State:MS
Practice Address - Zip Code:39577-2204
Practice Address - Country:US
Practice Address - Phone:016-928-4421
Practice Address - Fax:601-928-3967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy