Provider Demographics
NPI:1184765323
Name:WHITSON PHARMACY, INC.
Entity type:Organization
Organization Name:WHITSON PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT SUPERVISING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:BUTTON
Authorized Official - Last Name:MEATH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:315-548-9454
Mailing Address - Street 1:110 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PHELPS
Mailing Address - State:NY
Mailing Address - Zip Code:14532-1017
Mailing Address - Country:US
Mailing Address - Phone:315-548-9454
Mailing Address - Fax:315-548-9454
Practice Address - Street 1:110 MAIN ST
Practice Address - Street 2:
Practice Address - City:PHELPS
Practice Address - State:NY
Practice Address - Zip Code:14532-1017
Practice Address - Country:US
Practice Address - Phone:315-548-9454
Practice Address - Fax:315-548-5224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0122423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy