Bill E Blalack, RPH Valid NPI
Individual provider · Pharmacist · Brookhaven, MS
- NPI
- 1194034264
- Type
- Individual (Type 1)
- Primary specialty
- Pharmacist
- Specialty group
- Pharmacy Service Providers
- Taxonomy code
- 183500000X
- License number
- PD05554 (AR)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2010-10-06
- Last updated
- 2010-10-06
Practice location
218 S Whitworth Ave
Brookhaven, MS 39601-3343
(601) 835-0370