Provider Demographics
NPI:1861820896
Name:WHITE PINE LAND COMPANY INC
Entity type:Organization
Organization Name:WHITE PINE LAND COMPANY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST / PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:MORGAN
Authorized Official - Last Name:FRALIX
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:843-264-3291
Mailing Address - Street 1:15 WEST ASHLAND STREET
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:SC
Mailing Address - Zip Code:29510
Mailing Address - Country:US
Mailing Address - Phone:843-264-3291
Mailing Address - Fax:843-264-5425
Practice Address - Street 1:15 WEST ASHLAND STREET
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:SC
Practice Address - Zip Code:29510
Practice Address - Country:US
Practice Address - Phone:843-264-3291
Practice Address - Fax:843-264-5425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-30
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC133603336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy