Provider Demographics
NPI:1790266898
Name:WHITE, TERRI C (RPH)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:C
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 1:802 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71295-2602
Mailing Address - Country:US
Mailing Address - Phone:318-435-7858
Mailing Address - Fax:318-435-7122
Practice Address - Street 1:802 ADAMS ST
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:LA
Practice Address - Zip Code:71295-2602
Practice Address - Country:US
Practice Address - Phone:318-435-7858
Practice Address - Fax:318-435-7122
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy