Healthcare Provider Details

I. General information

NPI: 1821380684
Provider Name (Legal Business Name): EVERETT DILLARD WHITSON RPH PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: EVERETT DILLARD WHITSON RPH

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 05/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 GAINESBORO HWY
CELINA TN
38551
US

IV. Provider business mailing address

932 OLD GAINESBORO HWY
COOKEVILLE TN
38501-8939
US

V. Phone/Fax

Practice location:
  • Phone: 931-243-2673
  • Fax: 931-243-4691
Mailing address:
  • Phone: 931-267-0993
  • Fax: 931-243-4691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0000007427
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: