Provider Demographics
NPI:1366596314
Name:WHITE STONE PHARMACY, INC.
Entity type:Organization
Organization Name:WHITE STONE PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MASON
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:804-435-1051
Mailing Address - Street 1:PO BOX 3
Mailing Address - Street 2:VSR 200
Mailing Address - City:WHITE STONE
Mailing Address - State:VA
Mailing Address - Zip Code:22578-0003
Mailing Address - Country:US
Mailing Address - Phone:804-435-1051
Mailing Address - Fax:804-435-3784
Practice Address - Street 1:416 CHESAPEAKE DR
Practice Address - Street 2:VSR 200
Practice Address - City:WHITE STONE
Practice Address - State:VA
Practice Address - Zip Code:22578-0003
Practice Address - Country:US
Practice Address - Phone:804-435-1051
Practice Address - Fax:804-435-3784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02010028203336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy