Blanding Pharmacy & Medical Supply, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

PH25156 Issued in FL

Legal business name

BLANDING PHARMACY & MEDICAL SUPPLY, LLC

Practice address

5136 Blanding Blvd
Jacksonville, FL 32210-7894

Phone

(904) 777-2223

Fax

(904) 777-2787

NPI assigned

Apr 5, 2016

Last updated

Apr 5, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Patrick James Williams, R.PH

Title

Owner/Manager

Phone

(904) 777-2223

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Blanding Pharmacy Other name

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1255794350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5136 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322107894",
            "telephone_number": "904-777-2223",
            "fax_number": "904-777-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5136 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322107894",
            "telephone_number": "904-777-2223",
            "fax_number": "904-777-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLANDING PHARMACY & MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-05",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "904-777-2223",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "PH25156",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PH25156",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "FL",
            "license": "PH25156",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0031111600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blanding Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Johnitta Bland, RRT
• Justin A. Bland, A.T.
• Samantha Nicole Bland
• Shawna Bland
• Blanding Health Mart Pharmacy, LLC
• Charlotte E Blanding, ED.D
• Luz Blando
• Marcel Blanfort
• Christine O'Reilly Blank, CAA
• Robert D Blanken, PA

• Pharmacy in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.