Blands Drug Store

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

SP0550017 Issued in WV

Legal business name

BLANDS DRUG STORE

Practice address

217 W Pike St
Clarksburg, WV 26301-2750

Phone

(304) 624-5491

Fax

(304) 623-0830

NPI assigned

Jun 20, 2005

Organization subpart

No

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

Authorized official

Name

Brenda Fox

Title

Pic

Phone

(304) 624-5491

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• BLANDS DRUG STORE Doing business as

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189641600000",
    "number": "1790780377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 W PIKE ST",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263012750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 W PIKE ST",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263012750",
            "telephone_number": "304-624-5491",
            "fax_number": "304-623-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLANDS DRUG STORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-20",
        "last_updated": "2007-09-13",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "304-624-5491"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "WV",
            "license": "SP0550017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8500169",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0139685000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "5000980",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLANDS DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Compounding Pharmacy in Clarksburg, WV
• Providers in Clarksburg, WV by specialty
• Compounding Pharmacy in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; 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.