Provider Demographics
NPI:1679789242
Name:WHITE COLUMNS CONSULTING, INC.
Entity Type:Organization
Organization Name:WHITE COLUMNS CONSULTING, INC.
Other - Org Name:LIBERTY SQUARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILTON
Authorized Official - Middle Name:CLINTON
Authorized Official - Last Name:MEEKS
Authorized Official - Suffix:III
Authorized Official - Credentials:RPH
Authorized Official - Phone:706-554-7000
Mailing Address - Street 1:119 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30830-1459
Mailing Address - Country:US
Mailing Address - Phone:706-554-7000
Mailing Address - Fax:706-437-0752
Practice Address - Street 1:119 W 6TH ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:GA
Practice Address - Zip Code:30830-1459
Practice Address - Country:US
Practice Address - Phone:706-554-7000
Practice Address - Fax:706-437-0752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0088433336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1152177OtherNCPDP
GA1152177OtherNCPDP