Terry Lynn Blasingame

Individual provider Active NPI Pharmacist · Lake Arrowhead, CA

NPI 1609329010 · NPPES record last updated Aug 2, 2016

Key facts

NPI
1609329010
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
32758 (CA)
Practice address
28200 Highway 189 # N150
Lake Arrowhead, CA 92352-9700
Phone
(909) 336-3999
Fax
(909) 336-3997
NPI assigned
Aug 2, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
32758CAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 32758 CA Yes

Addresses

Primary practice location

28200 Highway 189 # N150
Lake Arrowhead, CA 92352-9700

Mailing address

PO Box 167
Lake Arrowhead, CA 92352-0167
Phone (909) 336-3999

Other providers in Lake Arrowhead, CA

All providers in Lake Arrowhead, CA · Pharmacist in California

Sources for this page

Verify at the official NPI Registry.