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General NPI Number Information
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NPI Number | 1154923951
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Entity Type | Individual
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Provider Name | LUKE WHITEHEAD PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 306 W ATLANTIC ST
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City | EMPORIA
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State | VA
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Zip | 23847-1206
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Country | US
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Telephone | 434-348-3181
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Fax |
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Provider Business Mailing Address
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Address Line | 16466 LINE PINE RD
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City | FRANKLIN
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State | VA
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Zip | 23851-3526
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Country | US
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Telephone | 757-653-1572
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202217961
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License Number State | VA
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