Healthcare Provider Details

I. General information

NPI: 1417567728
Provider Name (Legal Business Name): WHITE'S INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2020
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 LINCOLN ST
SITKA AK
99835-7540
US

IV. Provider business mailing address

117 GRANITE CREEK RD STE 201
SITKA AK
99835-9578
US

V. Phone/Fax

Practice location:
  • Phone: 907-966-2110
  • Fax: 907-966-2190
Mailing address:
  • Phone: 907-966-2102
  • Fax: 907-966-3979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TRISH D WHITE
Title or Position: VICE PRESIDENT WHITE'S INC
Credential: RPH
Phone: 907-966-2102