Healthcare Provider Details

I. General information

NPI: 1245580893
Provider Name (Legal Business Name): CAROL WHITE JUSTICE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROL LYNETTE WHITE PHARMD

II. Dates (important events)

Enumeration Date: 09/11/2012
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2629 CALUMET DR SE
BROWNSBORO AL
35741-9379
US

IV. Provider business mailing address

2629 CALUMET DR SE
BROWNSBORO AL
35741-9379
US

V. Phone/Fax

Practice location:
  • Phone: 615-946-7286
  • Fax:
Mailing address:
  • Phone: 615-946-7286
  • Fax: 615-591-1102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number33608
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: