Active NPI
Michael John White, RPH
- Pharmacist
- Queen Creek, AZ
National Provider Identifier
1255056073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S011624
- Practice address
- 3111 W Hunt Hwy
Queen Creek, AZ 85142-9357 - Phone
- (480) 214-2561
- Fax
- (480) 214-2565
- NPI assigned
- Oct 4, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S011624 | AZ | Primary |
Addresses
Primary practice location
3111 W Hunt Hwy
Queen Creek, AZ 85142-9357
Mailing address
3111 W Hunt Hwy
Queen Creek, AZ 85142-9357
Phone (480) 214-2561
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S011624 | Other | AZ | REGISTERED PHARMACIST - IMMUNIZER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S011624 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
3111 W Hunt Hwy
San Tan Valley, AZ 85144
Phone (480) 214-2561
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664841600000",
"number": "1255056073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3111 W HUNT HWY",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851429357",
"telephone_number": "480-214-2561",
"fax_number": "480-214-2565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3111 W HUNT HWY",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851429357",
"telephone_number": "480-214-2561",
"fax_number": "480-214-2565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "MICHAEL",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-04",
"last_updated": "2022-10-04",
"certification_date": "2022-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S011624",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED PHARMACIST - IMMUNIZER",
"identifier": "S011624",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Queen Creek, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.