Organization
BLACKBURN DRUG LLC
Active
Other names
Blackburn Drug
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES EDWARD BLACKBURN JR. PHARMD (OWNER)
(307) 201-1159
Entity
Organization
Contact information
Practice address
545 N CACHE ST UNIT 10-S, JACKSON, WY 83001-8685
(307) 201-1159
(307) 201-1553
Mailing address
PO BOX 11540, JACKSON, WY 83002-1540
(307) 201-1159
(307) 201-1553
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
05/31/2021
Last updated
03/07/2023
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