Provider Demographics
NPI:1285763193
Name:WHITE, LESLIE ELAINE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ELAINE
Last Name:WHITE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 LIMESTONE WAY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22406-7466
Mailing Address - Country:US
Mailing Address - Phone:540-372-4146
Mailing Address - Fax:
Practice Address - Street 1:1095 INTERNATIONAL PARKWAY
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22406
Practice Address - Country:US
Practice Address - Phone:540-286-0154
Practice Address - Fax:540-286-0745
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206842183500000X
NE10664183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist