Organization
BLANDING PHARMACY & MEDICAL SUPPLY, LLC
Active
Other names
Blanding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK JAMES WILLIAMS R.PH (OWNER/MANAGER)
(904) 777-2223
Entity
Organization
Contact information
Practice address
5136 BLANDING BLVD, JACKSONVILLE, FL 32210-7894
(904) 777-2223
(904) 777-2787
Mailing address
5136 BLANDING BLVD, JACKSONVILLE, FL 32210-7894
(904) 777-2223
(904) 777-2787
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PH25156
FL
333600000X
Pharmacy
Primary
PH25156
FL
3336C0004X
Compounding Pharmacy
PH25156
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0031111600
—
FL
Enumeration date
04/05/2016
Last updated
04/05/2016
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