1760531354 NPI number — DR. MARY ANNE MCCARRY WHYTE PHARMD

Table of content: DR. MARY ANNE MCCARRY WHYTE PHARMD (NPI 1760531354)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760531354 NPI number — DR. MARY ANNE MCCARRY WHYTE PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHYTE
Provider First Name:
MARY ANNE
Provider Middle Name:
MCCARRY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
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:
1760531354
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/26/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
799 DEERBROOKE TRL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUBURN
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95603-6070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-595-8955
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2341 SUNSET BLVD
Provider Second Line Business Practice Location Address:
BEL AIR 518
Provider Business Practice Location Address City Name:
ROCKLIN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95765-4337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-632-0184
Provider Business Practice Location Address Fax Number:
916-632-3796
Provider Enumeration Date:
01/10/2007

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:  PHARMACY48892 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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