Healthcare Provider Details

I. General information

NPI: 1487257333
Provider Name (Legal Business Name): CALLEE BLANKENBECKLER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2020
Last Update Date: 11/20/2020
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 CLAYPOOL HILL MALL RD
CEDAR BLUFF VA
24609-7013
US

IV. Provider business mailing address

35332 LOVES MILL RD
GLADE SPRING VA
24340-4122
US

V. Phone/Fax

Practice location:
  • Phone: 276-964-5748
  • Fax:
Mailing address:
  • Phone: 276-429-5270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202216827
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: