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General NPI Number Information
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NPI Number | 1215349956
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Entity Type | Organization
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Legal Business Name | BLAIR PHARMACY INC.
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Dates
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Enumeration Date | 05/29/2014
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 1818 POT SPRING RD STE 12
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City | LUTHERVILLE
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State | MD
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Zip | 21093-4499
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Country | US
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Telephone | 410-493-4699
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Fax | 410-561-0307
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Provider Business Mailing Address
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Address Line | 1818 POT SPRING RD STE 12
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City | LUTHERVILLE
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State | MD
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Zip | 21093-4499
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Country | US
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Telephone | 410-493-4699
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Fax | 410-561-0307
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Authorized Official
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Title or Position | OWNER
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Name | MR. MATTHEW E BLAIR
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Credential |
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Telephone | 410-493-4699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P06421
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License Number State | MD
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