Healthcare Provider Details

I. General information

NPI: 1164078382
Provider Name (Legal Business Name): CAMPBELL WHITE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2019
Last Update Date: 06/14/2025
Certification Date: 06/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2817 ROCK MERRITT AVENUE
FORT BRAGG NC
28310-3424
US

IV. Provider business mailing address

2817 ROCK MERRITT AVE
FORT BRAGG NC
28310-9026
US

V. Phone/Fax

Practice location:
  • Phone: 910-907-6337
  • Fax:
Mailing address:
  • Phone: 910-907-6337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28825
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: