Provider Demographics
NPI:1730488925
Name:WHITE, DEE ANN (RPH)
Entity Type:Individual
Prefix:MS
First Name:DEE
Middle Name:ANN
Last Name:WHITE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 KANAWHA BLVD E
Mailing Address - Street 2:APT, 210
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-3051
Mailing Address - Country:US
Mailing Address - Phone:304-993-4823
Mailing Address - Fax:
Practice Address - Street 1:406 WASHINGTON ST W
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-2131
Practice Address - Country:US
Practice Address - Phone:304-343-8807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0003084183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist