Individual
DOUGLAS R WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
220 1/2 3RD AVE, PROCTOR, MN 55810
(218) 628-9368
Mailing address
1935 LAKEVIEW DR, CARLTON, MN 55718-8239
(218) 590-4087
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
113629
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113629
MINNESOTA PHARMACIST LICENSE
MN
Enumeration date
05/19/2021
Last updated
05/19/2021
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