Organization
ROBERT A BLAKE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT A BLAKE RPH (OWNER)
(937) 544-2451
Entity
Organization
Contact information
Practice address
206 N MARKET ST, WEST UNION, OH 45693-1307
(937) 544-2451
Mailing address
206 N MARKET ST, WEST UNION, OH 45693-1307
(937) 544-2451
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
021171650
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2137520
—
OH
Enumeration date
09/27/2006
Last updated
11/19/2015
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