Provider Demographics
NPI:1508892175
Name:WHITE'S PHARMACY, INC.
Entity Type:Organization
Organization Name:WHITE'S PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:WHITE
Authorized Official - Last Name:PIPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-928-4421
Mailing Address - Street 1:301 FIFTH AVE W
Mailing Address - Street 2:
Mailing Address - City:WIGGINS
Mailing Address - State:MS
Mailing Address - Zip Code:39577-2204
Mailing Address - Country:US
Mailing Address - Phone:601-928-4421
Mailing Address - Fax:601-928-3967
Practice Address - Street 1:301 FIFTH AVE W
Practice Address - Street 2:
Practice Address - City:WIGGINS
Practice Address - State:MS
Practice Address - Zip Code:39577-2204
Practice Address - Country:US
Practice Address - Phone:601-928-4421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSCS00470101.1183500000X
MS332B00000X
333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00035041Medicaid
MS0440233Medicaid
MS0692650001Medicare PIN
MS0692650001Medicare NSC