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General NPI Number Information
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NPI Number | 1366041501
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Entity Type | Organization
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Legal Business Name | WHITE NILE
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 07/01/2021
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Provider Practice Location Address
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Address Line | 4338 W THOMAS RD UNIT E5
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City | PHOENIX
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State | AZ
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Zip | 85031-3878
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Country | US
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Telephone | 484-620-3937
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Fax |
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Provider Business Mailing Address
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Address Line | 11034 N 28TH DR UNIT 308
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City | PHOENIX
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State | AZ
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Zip | 85029-4380
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Country | US
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Telephone | 484-620-3937
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. KAMAL K SAEID
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Credential | PHARMD
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Telephone | 484-620-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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