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General NPI Number Information
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NPI Number | 1952901209
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Entity Type | Individual
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Provider Name | CASEY WHITAKER PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 400 OLD FRANKLIN TPKE
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City | ROCKY MOUNT
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State | VA
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Zip | 24151-5857
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Country | US
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Telephone | 540-483-2667
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Fax | 540-483-1624
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Provider Business Mailing Address
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Address Line | 70 HOLLY KNOLL DR
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City | ROCKY MOUNT
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State | VA
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Zip | 24151-2132
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Country | US
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Telephone | 540-493-5993
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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 | P9866
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH70768
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202212247
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License Number State | VA
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