Alexander Gray Blanton Sr., RPH
Individual provider Active NPI Pharmacist · Front Royal, VA
NPI 1124693585 · NPPES record last updated May 26, 2021
Key facts
- NPI
- 1124693585
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202004309 (VA)
- Practice address
- 234 Walnut Dr
Front Royal, VA 22630-2349 - Phone
- (540) 635-4483
- NPI assigned
- May 26, 2021
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0202004309 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202004309 | VA | Yes |
Addresses
Primary practice location
234 Walnut Dr
Front Royal, VA 22630-2349
Mailing address
409 South St
Front Royal, VA 22630-2115
Phone (540) 635-2249
Other providers in Front Royal, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.