1205979127 NPI number — WHITE'S INC

Table of content: (NPI 1205979127)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205979127 NPI number — WHITE'S INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WHITE'S INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HARRY RACE PHARMACY
Provider Other Organization Name Type Code:
3
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:
1205979127
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
106 LINCOLN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SITKA
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99835-7540
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-747-8666
Provider Business Mailing Address Fax Number:
907-966-3979

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 LINCOLN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SITKA
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99835-7540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-747-8666
Provider Business Practice Location Address Fax Number:
907-966-3979
Provider Enumeration Date:
02/14/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WHITE
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
DIANE
Authorized Official Title or Position:
VICE-PRESIDENT
Authorized Official Telephone Number:
907-747-8666

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  662 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 183500000X , with the licence number: 797 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 183500000X , with the licence number: 811 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 183500000X , with the licence number: 1268 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 183500000X , with the licence number: 1423 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 183500000X , with the licence number: 1153 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 183700000X , with the licence number: 2144 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 183700000X , with the licence number: 2145 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 183700000X , with the licence number: 2146 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 0201878 . This is a "BLUE CROSS OF WA AND AK" identifier , issued by the state of ( AK ) . This identifiers is of the category "OTHER".
  • Identifier: PH0600 , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".
  • Identifier: MS0656 , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".