Individual
CHARLES LEE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1187 SOUTHPORT AVE, CUYAHOGA FALLS, OH 44221-5582
(330) 472-4072
(330) 926-1474
Mailing address
1187 SOUTHPORT AVE, CUYAHOGA FALLS, OH 44221-5582
(330) 472-4072
(330) 926-1474
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03213285
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03213285
STATE OF OHIO BOARD OF PHARMACY
OH
Enumeration date
01/04/2021
Last updated
01/04/2021
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