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General NPI Number Information
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NPI Number | 1043474851
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Entity Type | Individual
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Provider Name | COURTNEY BLACKWELL ISOM PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 08/22/2014
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Provider Practice Location Address
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Address Line | 201 E WENDOVER AVE
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City | GREENSBORO
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State | NC
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Zip | 27401-1205
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Country | US
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Telephone | 336-832-3631
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Fax | 336-832-3632
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Provider Business Mailing Address
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Address Line | 201 E WENDOVER AVE
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City | GREENSBORO
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State | NC
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Zip | 27401-1205
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Country | US
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Telephone | 336-832-3631
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Fax | 336-832-3632
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 20244
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH024324
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 0070-00329
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License Number State | NC
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