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General NPI Number Information
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NPI Number | 1619958105
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Entity Type | Individual
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Provider Name | MARY ELIZABETH MARTINEAU WHITE R.PH
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Gender | Female
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 7131 HIGHWAY 73
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City | DENVER
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State | NC
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Zip | 28037-9186
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Country | US
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Telephone | 48-288-2287
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Fax |
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Provider Business Mailing Address
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Address Line | 3472 LAKE SHORE RD S
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City | DENVER
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State | NC
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Zip | 28037-8234
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Country | US
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Telephone | 419-799-9301
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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 | 25670
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License Number State | NC
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