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General NPI Number Information
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NPI Number | 1518018290
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Entity Type | Organization
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Legal Business Name | WHITES PHARMACY OF DALTON LLC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 03/13/2017
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Provider Practice Location Address
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Address Line | 2955B CLEVELAND RD
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City | DALTON
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State | GA
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Zip | 30721-8004
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Country | US
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Telephone | 706-259-9707
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Fax | 706-259-2278
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Provider Business Mailing Address
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Address Line | 2955B CLEVELAND RD
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City | DALTON
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State | GA
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Zip | 30721-8004
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Country | US
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Telephone | 706-259-9707
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Fax | 706-259-2278
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Authorized Official
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Title or Position | OWNER/PIC
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Name | RICHARD CRUMPTON
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Credential | RPH
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Telephone | 706-259-9707
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHRE007200
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License Number State | GA
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