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Organization
BLAKE PHARMACY
Active
Organization
BLAKE PHARMACY
Active
Other names
Blake Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DUSTIN CAMPBELL (PHARMACIST/MGR)
(937) 587-3100
Entity
Organization
Contact information
Practice address
103 N MAIN ST, PEEBLES, OH 45660-1246
(937) 587-3100
(937) 587-5045
Mailing address
103 N MAIN ST, PEEBLES, OH 45660-1246
(937) 587-3100
(937) 587-5045
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
022368600
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0315297
—
OH
01
—
2143874
PK
—
Enumeration date
08/17/2006
Last updated
02/20/2017
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