MEDICARE: DR. ALENA MARIE WHITE PHARM.D., R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH56533	CA

General Provider Information

NPI Number	:	1720232663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALENA MARIE WHITE PHARM.D., R.PH.

Provider Business Mailing Address
First Line	:	711 E MARKET ST
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95202-3104
Country	:	US
Telephone Number	:	209-465-1001
Fax Number	:

Provider Business Practice Location Address
First Line	:	711 E MARKET ST
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95202-3104
Country	:	US
Telephone Number	:	209-465-1001
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2008
Last Update Date	:	12/16/2015

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