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General NPI Number Information
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NPI Number | 1649810201
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Entity Type | Individual
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Provider Name | NICHOLAS TANNER WHITE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/12/2020
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 133 S RIDGE ST
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City | DANVILLE
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State | VA
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Zip | 24541-1313
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Country | US
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Telephone | 434-791-4880
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Fax |
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Provider Business Mailing Address
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Address Line | 1507 COUNTY LINE RD
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City | BASSETT
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State | VA
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Zip | 24055-5140
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Country | US
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Telephone | 276-224-3523
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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 | 29244
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License Number State | NC
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