Provider Demographics
NPI:1316552250
Name:BLANKENSHIP, JOSEPH (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:BLANKENSHIP
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 NOLTEMEYER WAY APT 1A
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-5958
Mailing Address - Country:US
Mailing Address - Phone:270-505-9772
Mailing Address - Fax:
Practice Address - Street 1:635 S DIXIE BLVD
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-1219
Practice Address - Country:US
Practice Address - Phone:270-352-0880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY018913183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist