Healthcare Provider Details

I. General information

NPI: 1831093897
Provider Name (Legal Business Name): JOHN WHITE PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TAMBERLINE ST
BRANDON MS
39042-3162
US

IV. Provider business mailing address

200 TAMBERLINE ST
BRANDON MS
39042-3162
US

V. Phone/Fax

Practice location:
  • Phone: 601-825-2897
  • Fax:
Mailing address:
  • Phone: 601-825-2897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberE-09588
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: