# BLAKE PHARMACY , INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245325844
- **Authorized official:** MRS. KATHLEEN D HILL R.PH. (MANAGER)
- **Authorized official phone:** (937) 549-3773

## Contact information

- **Practice address:** 35 E SECOND ST, MANCHESTER, OH 45144-1301
- **Practice address phone:** (937) 549-3773
- **Practice address fax:** (937) 549-3714
- **Mailing address:** 35 E SECOND ST, MANCHESTER, OH 45144-1301
- **Mailing address phone:** (937) 549-3773
- **Mailing address fax:** (937) 549-3714

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 02-0481050 | OH | Yes |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 08/29/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0642871 | — | OH |