Healthcare Provider Details

I. General information

NPI: 1376305359
Provider Name (Legal Business Name): CHRISTIAN BLAKE ALLEN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2024
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PEPPERELL PKWY STE 292
OPELIKA AL
36801-5452
US

IV. Provider business mailing address

1477 N DONAHUE DR APT 1604
AUBURN AL
36830-0217
US

V. Phone/Fax

Practice location:
  • Phone: 334-528-2293
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24661
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: