Active NPI
Dave W Blackwell, RPH
- Pharmacist
- Lutz, FL
National Provider Identifier
1801237409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS37967
- Practice address
- 1930 Land O Lakes Blvd
Lutz, FL 33549-2999 - Phone
- (813) 948-4500
- NPI assigned
- Jul 11, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS37967 | FL | Primary |
Addresses
Primary practice location
1930 Land O Lakes Blvd
Lutz, FL 33549-2999
Mailing address
4626 Tailfeather CT
Land O Lakes, FL 34639-6401
Phone (813) 235-6292
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS37967 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373500800000",
"number": "1801237409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4626 TAILFEATHER CT",
"city": "LAND O LAKES",
"state": "FL",
"postal_code": "346396401",
"telephone_number": "813-235-6292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1930 LAND O LAKES BLVD",
"city": "LUTZ",
"state": "FL",
"postal_code": "335492999",
"telephone_number": "813-948-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWELL",
"first_name": "DAVE",
"middle_name": "W",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-11",
"last_updated": "2013-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS37967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lutz, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.