Michael Blackburn in Maryville - Pharmacist
Michael Blackburn - NPI 1225236284
Michael Blackburn is a Pharmacist in Maryville, Illinois. Michael Blackburn practices all healthcare services and medical treatments related to Pharmacist. The NPI Number for Michael Blackburn is 1225236284. The last update date is 2008-09-08.
Michael Blackburn's current location address is 30 Foxmoor Dr, Maryville, Illinois. You can contact this provider via phone number 3143430194. The mailing address for Michael Blackburn is 30 Foxmoor Dr, Maryville, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Michael Blackburn |
|---|---|
| Address | 30 Foxmoor Dr, Maryville, Illinois |
| Phone Number | 3143430194 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | RPH |
NPI Number Detail
| NPI Number | 1225236284 |
|---|---|
| Provider Enumeration Date | 2007-07-10 |
| Last Updated Date | 2008-09-08 |
Provider Mailing Address Detail
| Address | 30 Foxmoor Dr |
|---|---|
| City | Maryville |
| State | Illinois (IL) |
| Post Code | 620626731 |
| Phone Number | 3143430194 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pharmacist |
|---|---|
| Taxonomy | 183500000X |
| Licence No | 2004017958 |
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Definition: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or m |
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What is the unique 10-digit identification code assigned to Michael Blackburn by the Centers for Medicare & Medicaid Services?
The Michael Blackburn has been issued the NPI (National Provider Identifier) 1225236284, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Michael Blackburn located?
The Michael Blackburn is located at 30 Foxmoor Dr, Maryville, IL 620626731.
What is Michael Blackburn's specialized field of practice, and what is the corresponding taxonomy classification code?
The Michael Blackburn's area of specialization is Pharmacist, and the corresponding taxonomy code that categorizes this field of practice is 183500000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1225236284 to Michael Blackburn?
The Centers for Medicare & Medicaid Services originally issued the 1225236284 to Michael Blackburn on 2007-07-10.
As of what date were the details related to Michael Blackburn most recently updated or revised?
The information pertaining to Michael Blackburn, including its address, specialty, and other relevant details, was last updated or revised on 2008-09-08.