Active NPI
Otis Malcolm Blair, PHARMACIST
- Pharmacist
- Bremerton, WA
National Provider Identifier
1023022043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00007107
- Practice address
- 616 6TH St
Bremerton, WA 98337-1420 - Phone
- (360) 475-3732
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH00007107 | WA | Primary |
Addresses
Primary practice location
616 6TH St
Bremerton, WA 98337-1420
Mailing address
PO Box 960
Bremerton, WA 98337-0212
Phone (360) 475-3732
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH00007107 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023022043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 960",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983370212",
"telephone_number": "360-475-3732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "616 6TH ST",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983371420",
"telephone_number": "360-475-3732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAIR",
"first_name": "OTIS",
"middle_name": "MALCOLM",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00007107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bremerton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.