1033442199 NPI number — DR. CASSONDRA M WHITE PHARM.D.

Table of content: MRS. ELIZABETH WONG LCSW (NPI 1689024432)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033442199 NPI number — DR. CASSONDRA M WHITE PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHITE
Provider First Name:
CASSONDRA
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033442199
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/08/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 450
Provider Second Line Business Mailing Address:
SFF ADMIN BLG ROOM AO-149
Provider Business Mailing Address City Name:
BRUCETON MILLS
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26525-0450
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-379-5515
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 SKYVIEW DR
Provider Second Line Business Practice Location Address:
SFF ADMIN BLG ROOM AO-149
Provider Business Practice Location Address City Name:
BRUCETON MILLS
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26525-0450
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-379-5515
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/08/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  18894 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com