Provider Demographics
NPI:1154923951
Name:WHITEHEAD, LUKE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LUKE
Middle Name:
Last Name:WHITEHEAD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16466 LINE PINE RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:VA
Mailing Address - Zip Code:23851-3526
Mailing Address - Country:US
Mailing Address - Phone:757-653-1572
Mailing Address - Fax:
Practice Address - Street 1:306 W ATLANTIC ST
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:VA
Practice Address - Zip Code:23847-1206
Practice Address - Country:US
Practice Address - Phone:434-348-3181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202217961183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist