Provider Demographics
NPI:1275215634
Name:BLANE MANAGEMENT LLC
Entity Type:Organization
Organization Name:BLANE MANAGEMENT LLC
Other - Org Name:DOVER FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:MARLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-232-0123
Mailing Address - Street 1:1307 DONELSON PKWY
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:TN
Mailing Address - Zip Code:37058-3724
Mailing Address - Country:US
Mailing Address - Phone:931-232-0123
Mailing Address - Fax:931-232-1185
Practice Address - Street 1:1307 DONELSON PKWY
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:TN
Practice Address - Zip Code:37058-3724
Practice Address - Country:US
Practice Address - Phone:931-232-0123
Practice Address - Fax:931-232-1185
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLANE MANAGEMENT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-04
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy