Healthcare Provider Details

I. General information

NPI: 1700441185
Provider Name (Legal Business Name): MEDICAL ARTS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2019
Last Update Date: 05/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 RUIN CREEK RD
HENDERSON NC
27536-5916
US

IV. Provider business mailing address

253 RUIN CREEK RD
HENDERSON NC
27536-5916
US

V. Phone/Fax

Practice location:
  • Phone: 252-492-3404
  • Fax: 252-433-4649
Mailing address:
  • Phone: 252-492-3404
  • Fax: 252-433-4649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State

VIII. Authorized Official

Name: CHARLES CRAIG WHITE
Title or Position: OWNER/PRESIDENT/RPH
Credential: RPH
Phone: 252-492-3404