Blackburns Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

021761650 Issued in OH

Legal business name

BLACKBURNS PHARMACY LLC

Doing business as

Blackburns Pharmacy LLC

Practice address

3520 Rhodes Ave
New Boston, OH 45662-4975

Phone

(740) 456-4500

Fax

(740) 456-4544

NPI assigned

Sep 19, 2007

Last updated

Sep 10, 2015By 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

Roger Flautt, RPH

Title

Pic,Ao

Phone

(740) 456-4500

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• BLACKBURNS PHARMACY LLC Doing business as

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441843200000",
    "number": "1417143843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 RHODES AVE",
            "city": "NEW BOSTON",
            "state": "OH",
            "postal_code": "456624975",
            "telephone_number": "740-456-4500",
            "fax_number": "740-456-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 RHODES AVE",
            "city": "NEW BOSTON",
            "state": "OH",
            "postal_code": "456624975",
            "telephone_number": "740-456-4500",
            "fax_number": "740-456-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKBURNS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2015-09-10",
        "status": "A",
        "authorized_official_last_name": "FLAUTT",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "PIC,AO",
        "authorized_official_telephone_number": "740-456-4500",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "021761650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2784527",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2081085",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLACKBURNS PHARMACY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carolyn Marie Baker, MD
• Emily Baker, OT/L
• Stephen D. Barker, RPH
• Cassidy Rose Berry
• Justin Ryan Blackburn
• Jason Eric Blair
• Joshua Paul Blevins Sr., CCTEMT-P
• Stephanie Ann Bowman
• David Wayne Brickey
• Bridgeworks Counseling and Consulting Inc

• Community/Retail Pharmacy in New Boston, OH
• Providers in New Boston, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.