Provider Demographics
NPI:1265665871
Name:WHITE, DANNY LEE (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:LEE
Last Name:WHITE
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2737 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-7907
Mailing Address - Country:US
Mailing Address - Phone:417-358-4321
Mailing Address - Fax:
Practice Address - Street 1:2737 GRAND AVE
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-7907
Practice Address - Country:US
Practice Address - Phone:417-358-4321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-30
Last Update Date:2009-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0041662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist