Charles Lee Blake, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

03213285 Issued in OH

Practice address

1187 Southport Ave
Cuyahoga Falls, OH 44221-5582

Phone

(330) 472-4072

Fax

(330) 926-1474

NPI assigned

Jan 4, 2021

Sex

Male

Sole proprietor

Yes

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

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1154919355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1187 SOUTHPORT AVE",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442215582",
            "telephone_number": "330-472-4072",
            "fax_number": "330-926-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1187 SOUTHPORT AVE",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442215582",
            "telephone_number": "330-472-4072",
            "fax_number": "330-926-1474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "CHARLES",
        "middle_name": "LEE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03213285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OHIO BOARD OF PHARMACY",
            "identifier": "03213285",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "email",
            "affiliation": "N",
            "endpointDescription": "address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1187 Southport Ave",
            "city": "Cuyahoga Falls",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442215582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jenny Bjork, LPCC, NCC
• Heidi Kristina Black, LSW
• Lateesha Black, BS, MBA
• Ross R Black II, MD
• Tamia Blackmon
• Tara Blake, COTA/L
• Patrick Blakeslee, DO
• Verlaine Blaser, DO
• Heidi Inge Wiedamann Blinka, LPT
• Beth Blondheim, M.A.

• Pharmacist in Cuyahoga Falls, OH
• Providers in Cuyahoga Falls, OH by specialty
• Pharmacist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; 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.