Provider Demographics
NPI:1366836496
Name:BLEVINS, DUANE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:
Last Name:BLEVINS
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 1:312 VERMILLION DR
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605-9349
Mailing Address - Country:US
Mailing Address - Phone:304-921-6195
Mailing Address - Fax:
Practice Address - Street 1:312 VERMILLION DR
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:VA
Practice Address - Zip Code:24605-9349
Practice Address - Country:US
Practice Address - Phone:304-921-6195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02020114831835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric