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LARRY BLANK PHARMACIST
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1609153998
Individual Registrant: LARRY BLANK PHARMACIST
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
30015 DATE PALM DR CATHEDRAL CITY, CA 92234-2822 US
Tel: 760-770-3659 Fax: 760-770-4203
Tel: 760-770-3659 Fax: 760-770-4203
Contact information for business:
30015 DATE PALM DR CATHEDRAL CITY, CA 92234-2822 US
Tel: 760-770-3659 Fax: 760-770-4203
Tel: 760-770-3659 Fax: 760-770-4203
Registration Information:
NPI: 1609153998
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | CA | 21818 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
