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General NPI Number Information
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NPI Number | 1285768341
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Entity Type | Individual
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Provider Name | KEVIN CHARLES WHITE R.PH.
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Gender | Male
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 10920 GRAND RIVER AVE
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City | DETROIT
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State | MI
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Zip | 48204-2052
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Country | US
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Telephone | 313-931-0010
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Fax | 313-934-1658
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Provider Business Mailing Address
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Address Line | 4579 LEHIGH DR
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City | TROY
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State | MI
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Zip | 48098-4406
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Country | US
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Telephone | 313-320-5200
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Fax | 313-934-1658
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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 | 5302024111
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 5302024111
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License Number State | MI
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