Healthcare Provider Details

I. General information

NPI: 1770573685
Provider Name (Legal Business Name): MARCIA WHITE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 US HIGHWAY 421
MCKEE KY
40447-9425
US

IV. Provider business mailing address

126 LONGVIEW DR
RICHMOND KY
40475-2232
US

V. Phone/Fax

Practice location:
  • Phone: 606-287-7104
  • Fax: 606-287-3348
Mailing address:
  • Phone: 859-624-2236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number011008
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: