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General NPI Number Information
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NPI Number | 1811012354
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Entity Type | Organization
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Legal Business Name | BLANCHARD DRUG & GIFT
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1203 N COUNCIL RD
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City | BLANCHARD
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State | OK
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Zip | 73010-8000
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Country | US
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Telephone | 405-485-2112
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Fax | 405-485-8661
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Provider Business Mailing Address
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Address Line | PO BOX 786
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City | BLANCHARD
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State | OK
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Zip | 73010-0786
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Country | US
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Telephone | 405-485-2112
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Fax | 405-485-8661
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LISA RENEA STANDRIDGE
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Credential | PHARM D
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Telephone | 405-485-2112
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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 | 47-3971
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License Number State | OK
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