Jerrick White, PHARM. D.
Individual provider Active NPI Pharmacist · Eads, TN
NPI 1124393764 · NPPES record last updated Mar 15, 2012
Key facts
- NPI
- 1124393764
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 10715 (TN)
- Practice address
- 1850 Latting Valley Rd
Eads, TN 38028-7008 - Phone
- (901) 861-5058
- NPI assigned
- Mar 15, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10715 | TN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 10715 | TN | Yes |
Addresses
Primary practice location
1850 Latting Valley Rd
Eads, TN 38028-7008
Mailing address
1850 Latting Valley Rd
Eads, TN 38028-7008
Phone (901) 861-5058
Other providers in Eads, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.