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General NPI Number Information
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NPI Number | 1932324811
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Entity Type | Individual
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Provider Name | JERRY ALLAN BLISS PHARMD,RPH,CCP
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Gender | Male
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1025 BOBWHITE DR
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City | CHERRY HILL
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State | NJ
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Zip | 08003-3103
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Country | US
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Telephone | 856-428-5762
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Fax | 856-428-5762
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Provider Business Mailing Address
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Address Line | 1025 BOBWHITE DR
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City | CHERRY HILL
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State | NJ
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Zip | 08003-3103
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Country | US
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Telephone | 856-428-5762
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Fax | 856-428-5762
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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 | 28RI01957000
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License Number State | NJ
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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 | RP038881R
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License Number State | PA
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