Individual
ROGER D BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
200 PATEWOOD DR, SUITE A12, GREENVILLE, SC 29615-3593
(864) 454-2369
Mailing address
255 ENTERPRISE BLVD, SUITE 250, GREENVILLE, SC 29615-6300
(864) 454-0888
(864) 454-1130
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8717
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8717
SC PHARMACIST IN CHARGE
SC
Enumeration date
06/22/2006
Last updated
07/08/2007
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