Provider Demographics
NPI:1124141585
Name:WHITMORE, MARILYNN T (RPH)
Entity type:Individual
Prefix:
First Name:MARILYNN
Middle Name:T
Last Name:WHITMORE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 BOUNTY LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-2303
Mailing Address - Country:US
Mailing Address - Phone:919-544-7739
Mailing Address - Fax:
Practice Address - Street 1:301 LLOYD ST
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-1823
Practice Address - Country:US
Practice Address - Phone:919-537-0097
Practice Address - Fax:919-929-0864
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist