Provider Demographics
NPI:1245580893
Name:JUSTICE, CAROL WHITE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:WHITE
Last Name:JUSTICE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:CAROL
Other - Middle Name:LYNETTE
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2629 CALUMET DR SE
Mailing Address - Street 2:
Mailing Address - City:BROWNSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35741-9379
Mailing Address - Country:US
Mailing Address - Phone:615-946-7286
Mailing Address - Fax:615-591-1102
Practice Address - Street 1:2629 CALUMET DR SE
Practice Address - Street 2:
Practice Address - City:BROWNSBORO
Practice Address - State:AL
Practice Address - Zip Code:35741-9379
Practice Address - Country:US
Practice Address - Phone:615-946-7286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33608183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist