Provider Demographics
NPI:1104195163
Name:WHITE'S HEALTHCARE ENTERPRISES INC,.
Entity Type:Organization
Organization Name:WHITE'S HEALTHCARE ENTERPRISES INC,.
Other - Org Name:PREMIER RX LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:FAZZINI
Authorized Official - Suffix:JR
Authorized Official - Credentials:REGISTERED PHARMACIS
Authorized Official - Phone:973-292-1166
Mailing Address - Street 1:60B SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-292-1166
Mailing Address - Fax:973-292-0140
Practice Address - Street 1:60B SOUTH ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-292-1166
Practice Address - Fax:973-292-0140
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHITE'S HEALTHCARE ENTERPRISES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00714400333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy