Healthcare Provider Details

I. General information

NPI: 1073429841
Provider Name (Legal Business Name): WHITE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17346 W MAPLE LN
GURNEE IL
60031-2763
US

IV. Provider business mailing address

9603 BIRD RIVER RD
MIDDLE RIVER MD
21220
US

V. Phone/Fax

Practice location:
  • Phone: 479-265-1075
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: PAMELA REYNOLDS
Title or Position: MANAGER
Credential:
Phone: 314-639-9213