Basic Information
| Provider Information | |||||||||
| NPI: | 1467809848 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WHITE | ||||||||
| FirstName: | DONNA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | RPH | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WHITE | ||||||||
| OtherFirstName: | DONNA | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PHARMACIST | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1222 JEFFERSON PARK AVE | ||||||||
| Address2: | UMA CLINIC UVA HEALTH SYSTEM | ||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229033410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4349824013 | ||||||||
| FaxNumber: | 4342435770 | ||||||||
| Practice Location | |||||||||
| Address1: | 1222 JEFFERSON PARK AVE | ||||||||
| Address2: | UMA CLINIC UVA HEALTH SYSTEM | ||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229033410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4349824013 | ||||||||
| FaxNumber: | 4342435770 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2016 | ||||||||
| LastUpdateDate: | 05/16/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P0018X | 0202007094 | VA | Y | Pharmacy Service Providers | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
No ID Information.