Provider Demographics
NPI:1376631481
Name:BLANK'S PHARMACIES, INC
Entity Type:Organization
Organization Name:BLANK'S PHARMACIES, INC
Other - Org Name:BLANK'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF PHARMACIST / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:BLANK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:859-261-1313
Mailing Address - Street 1:272 W PIKE ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-2343
Mailing Address - Country:US
Mailing Address - Phone:859-261-1313
Mailing Address - Fax:859-655-3042
Practice Address - Street 1:272 W PIKE ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-2343
Practice Address - Country:US
Practice Address - Phone:859-261-1313
Practice Address - Fax:859-655-3042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0143850001332B00000X
KYP003583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1804170OtherNCPDP
KY54005012Medicaid
KY90130592Medicaid
KY54005012Medicaid
KY0143850001Medicare NSC