Healthcare Provider Details

I. General information

NPI: 1508892175
Provider Name (Legal Business Name): WHITE'S PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 07/21/2022
Certification Date: 09/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 FIFTH AVE W
WIGGINS MS
39577-2204
US

IV. Provider business mailing address

301 FIFTH AVE W
WIGGINS MS
39577-2204
US

V. Phone/Fax

Practice location:
  • Phone: 601-928-4421
  • Fax:
Mailing address:
  • Phone: 601-928-4421
  • Fax: 601-928-3967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberCS00470101.1
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. REBECCA WHITE PIPKINS
Title or Position: OWNER
Credential:
Phone: 601-928-4421