Camille Blank

Primary specialty

PharmacistTaxonomy code 183500000X

License

352072-1701 Issued in UT

Practice address

4080 W 9000 S
West Jordan, UT 84088-8928

Phone

(801) 280-5545

NPI assigned

Oct 5, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Smiths Food & Drug Centers Inc

  • Community/Retail Pharmacy
  • West Jordan, UT
  • NPI 1407873029
  NPD (past)
• Smith'S Food & Drug Centers Inc

  • Community/Retail Pharmacy
  • Henderson, NV
  • NPI 1881585248
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570233600000",
    "number": "1093356594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 W 9000 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840888928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 W 9000 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840888928",
            "telephone_number": "801-280-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANK",
        "first_name": "CAMILLE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-05",
        "last_updated": "2019-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "352072-1701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352072-1701",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "OTHER",
            "affiliation": "N",
            "address_1": "4080 W 9000 S",
            "city": "West Jordan",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840888928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Blackbird Care
• Boyd Kent Bladen, DDS
• Carli Joye Blake
• Taylor Wade Blanco, O.D.
• Malaya Bland
• Connor Bliss
• Megan Bliss
• Trista Lee Blue
• Erinlee Boden, MPT, DPT
• Kathryn Collette Bogart

• Pharmacist in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Pharmacist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.