Samuel Aarin Blakeslee, RPH

Individual provider Active NPI Pharmacist · Casper, WY

NPI 1003459397 · NPPES record last updated Oct 20, 2019

Key facts

NPI
1003459397
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
4185 (WY)
Practice address
300 SE Wyoming Blvd
Casper, WY 82609-4201
Phone
(307) 577-7062
NPI assigned
Oct 20, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
4185WYMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 4185 WY Yes

Addresses

Primary practice location

300 SE Wyoming Blvd
Casper, WY 82609-4201

Mailing address

2935 Desmet Dr
Casper, WY 82604-3047
Phone (307) 399-9698

Other providers in Casper, WY

All providers in Casper, WY · Pharmacist in Wyoming

Sources for this page

Verify at the official NPI Registry.