Provider Demographics
NPI:1679058077
Name:WHITE OAK PHARMACY, LLC
Entity type:Organization
Organization Name:WHITE OAK PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:VA
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:III
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:919-803-6417
Mailing Address - Street 1:501 HEALTH PARK DR STE 170
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-7052
Mailing Address - Country:US
Mailing Address - Phone:919-803-6417
Mailing Address - Fax:919-803-6596
Practice Address - Street 1:501 HEALTH PARK DR STE 170
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-7052
Practice Address - Country:US
Practice Address - Phone:910-691-1022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy