Provider Demographics
NPI:1861459752
Name:WHITE, JULIA GRACE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:GRACE
Last Name:WHITE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5612 FOXVIEW CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1165
Mailing Address - Country:US
Mailing Address - Phone:410-531-3182
Mailing Address - Fax:410-730-8092
Practice Address - Street 1:9501 OLD ANNAPOLIS RD
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-6314
Practice Address - Country:US
Practice Address - Phone:410-730-8200
Practice Address - Fax:410-730-8092
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09382183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist