Provider Demographics
NPI:1720338197
Name:WHITE, TOM KIM (RPH)
Entity type:Individual
Prefix:MR
First Name:TOM
Middle Name:KIM
Last Name:WHITE
Suffix:
Gender:
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-6300
Mailing Address - Country:US
Mailing Address - Phone:575-887-5085
Mailing Address - Fax:575-887-8300
Practice Address - Street 1:202 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-6300
Practice Address - Country:US
Practice Address - Phone:575-887-5085
Practice Address - Fax:575-887-8300
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00004960183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist