Healthcare Provider Details

I. General information

NPI: 1275271033
Provider Name (Legal Business Name): MIRIAH WHITE PHARMD.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2022
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7045 OLD CANTON RD
RIDGELAND MS
39157-1036
US

IV. Provider business mailing address

106 WISTERIA HILL DR
FLOWOOD MS
39232-7418
US

V. Phone/Fax

Practice location:
  • Phone: 601-856-0977
  • Fax: 601-856-1492
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberE-100316
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberE-100316
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: