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General NPI Number Information
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NPI Number | 1689751794
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Entity Type | Individual
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Provider Name | ROBERT GALEN BLANKE R.PH.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 429 DELAWARE ST
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City | LEAVENWORTH
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State | KS
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Zip | 66048-2732
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Country | US
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Telephone | 913-682-1602
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Fax | 913-682-4220
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Provider Business Mailing Address
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Address Line | 24903 WOLCOTT RD
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City | LEAVENWORTH
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State | KS
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Zip | 66048-7234
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Country | US
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Telephone | 913-727-6118
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Fax |
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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 | 9017
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License Number State | KS
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