Healthcare Provider Details

I. General information

NPI: 1972430726
Provider Name (Legal Business Name): DELAINE M WHITE PHARM.D.
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 PINE TREE DRIVE
BIGFORK MN
56628
US

IV. Provider business mailing address

PO BOX 541
NORTHOME MN
56661-0541
US

V. Phone/Fax

Practice location:
  • Phone: 218-743-4444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number121006
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: