Blende Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

1040000004 Issued in CO

Legal business name

BLENDE DRUG INC

Practice address

1910 Santa Fe Dr
Pueblo, CO 81006-1452

Phone

(719) 542-2477

Fax

(719) 544-4469

NPI assigned

Aug 26, 2006

Organization subpart

No

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

Authorized official

Name

John Joseph Cernac

Title

RPH/President

Phone

(719) 542-2477

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• BLENDE DRUG INC Doing business as

Medicare fee-for-service enrollment

Enrolled in CO2 enrollments

Enrollment records 2

Tax ID family

Blende Drug Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Blende Drug Inc

  • Primary Care Clinic/Center
  • Pueblo, CO
  • NPI 1275336174
  NPD tax ID
• Blende Drug Inc

  • Long Term Care Pharmacy
  • Pueblo, CO
  • NPI 1730813684
  NPD tax ID

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

{
    "created_epoch": "1156550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1609984194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 SANTA FE DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810061452",
            "telephone_number": "719-542-2477",
            "fax_number": "719-544-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 SANTA FE DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810061452",
            "telephone_number": "719-542-2477",
            "fax_number": "719-544-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLENDE DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-26",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "CERNAC",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "RPH/PRESIDENT",
        "authorized_official_telephone_number": "719-542-2477"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CO",
            "license": "1040000004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2001139",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03094299",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLENDE DRUG INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BLENDE DRUG INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Destiny Blea
• Jessie Blea
• Obbrianna Blea
• Darya Blednova, MD
• Blende Drug Inc
• Blende Drug Inc
• Shelby Bley, LAT, ATC
• Elaine Louise Blinn
• Tylia Blissett
• Larry E. Blossom, M.A.

• Community/Retail Pharmacy in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Community/Retail Pharmacy in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.