Provider Demographics
NPI:1437462538
Name:WHITE, GEORGE ROBERT (RPH)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:ROBERT
Last Name:WHITE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26036 LANKFORD HWY
Mailing Address - Street 2:
Mailing Address - City:ONLEY
Mailing Address - State:VA
Mailing Address - Zip Code:23418-3005
Mailing Address - Country:US
Mailing Address - Phone:757-302-4096
Mailing Address - Fax:757-302-4090
Practice Address - Street 1:26036 LANKFORD HWY
Practice Address - Street 2:
Practice Address - City:ONLEY
Practice Address - State:VA
Practice Address - Zip Code:23418-3005
Practice Address - Country:US
Practice Address - Phone:757-302-4096
Practice Address - Fax:757-302-4090
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-17
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204251183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist