Healthcare Provider Details

I. General information

NPI: 1679058077
Provider Name (Legal Business Name): WHITE OAK PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2018
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 HEALTH PARK DR STE 170
GARNER NC
27529-7052
US

IV. Provider business mailing address

501 HEALTH PARK DR STE 170
GARNER NC
27529-7052
US

V. Phone/Fax

Practice location:
  • Phone: 910-691-1022
  • Fax:
Mailing address:
  • Phone: 919-803-6417
  • Fax: 919-803-6596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CURTIS TODD ILLIG
Title or Position: PHARMACY MANAGER
Credential: RPH
Phone: 919-803-6417