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Individual

DR. ROOSEVELT ALONZO BLYE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM.D

Contact information

Practice address
200 WEST RAILROAD STREET SUITE B, RITE AID, LONG BEACH, MS 39560-2269
(228) 864-0334
Mailing address
1593 RACHEL DRIVE, BILOXI, MS 39532
(228) 392-0112

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
09535
MS

Other

Enumeration date
04/18/2011
Last updated
04/18/2011
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