Healthcare Provider Details

I. General information

NPI: 1447578034
Provider Name (Legal Business Name): THOMAS CLIFFORD WHITE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2010
Last Update Date: 05/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 SUMMER ST
BRISTOL NH
03222-3213
US

IV. Provider business mailing address

360 SUMMER ST
BRISTOL NH
03222-3213
US

V. Phone/Fax

Practice location:
  • Phone: 603-744-2652
  • Fax: 603-744-3166
Mailing address:
  • Phone: 603-744-2652
  • Fax: 603-744-3166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2083
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: