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Organization

BLANDS DRUG STORE

Active
Other names
BLANDS DRUG STORE
Organization subpart
No

Provider details

NPI number
Authorized official
BRENDA FOX (PIC)
(304) 624-5491
Entity
Organization

Contact information

Practice address
217 W PIKE ST, CLARKSBURG, WV 26301-2750
(304) 624-5491
(304) 623-0830
Mailing address
217 W PIKE ST, CLARKSBURG, WV 26301-2750

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
3336C0004X
Compounding Pharmacy
Primary
SP0550017
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0139685000
WV
01
5000980
OTHER ID NUMBER
05
8500169
WV
Enumeration date
06/20/2005
Last updated
09/13/2007
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