Provider Demographics
NPI:1538700810
Name:WHITE DOVE PHARMACY, LLC.
Entity Type:Organization
Organization Name:WHITE DOVE PHARMACY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:MAZEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELHADJSAID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-367-6031
Mailing Address - Street 1:2751 NC 55 HWY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-6206
Mailing Address - Country:US
Mailing Address - Phone:919-367-6031
Mailing Address - Fax:
Practice Address - Street 1:2751 NC 55 HWY
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-6206
Practice Address - Country:US
Practice Address - Phone:919-367-6031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-08
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy