Provider Demographics
NPI:1124584008
Name:WHITE, DONNA O (RPH)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:O
Last Name:WHITE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 WESTWOOD PINE DR
Mailing Address - Street 2:
Mailing Address - City:MOSELEY
Mailing Address - State:VA
Mailing Address - Zip Code:23120-1182
Mailing Address - Country:US
Mailing Address - Phone:804-372-6512
Mailing Address - Fax:
Practice Address - Street 1:1950 ANDERSON HWY
Practice Address - Street 2:
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-7918
Practice Address - Country:US
Practice Address - Phone:804-464-9894
Practice Address - Fax:804-464-9888
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012631183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist