Healthcare Provider Details

I. General information

NPI: 1831125368
Provider Name (Legal Business Name): WHITES DRUGS OF RICHTON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 N FRONT ST
RICHTON MS
39476-2210
US

IV. Provider business mailing address

PO BOX 458
RICHTON MS
39476-0458
US

V. Phone/Fax

Practice location:
  • Phone: 601-788-6335
  • Fax: 601-788-6313
Mailing address:
  • Phone: 601-788-6335
  • Fax: 601-788-6313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JIMMY L WHITE
Title or Position: PHARMACIST/OWNER
Credential:
Phone: 601-788-6335