Organization
TRICARE PHARMACY NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAREN WHITE RPH (OWNER)
(859) 277-2271
Entity
Organization
Contact information
Practice address
1051 NEWTOWN PIKE STE 140, LEXINGTON, KY 40511-1245
(859) 277-2271
(859) 277-1532
Mailing address
1051 NEWTOWN PIKE STE 140, LEXINGTON, KY 40511-1245
(859) 277-2271
(859) 277-1532
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
P06668
KY
3336C0004X
Compounding Pharmacy
Primary
P06668
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1826948
NCPDP
—
01
—
P06668
PHARMACY PERMIT
KY
Enumeration date
02/27/2007
Last updated
03/07/2023
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