Provider Demographics
NPI:1538481387
Name:BLANKENSHIP, JAMES
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:BLANKENSHIP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 CONSTITUTION BLVD
Mailing Address - Street 2:
Mailing Address - City:WIRTZ
Mailing Address - State:VA
Mailing Address - Zip Code:24184
Mailing Address - Country:US
Mailing Address - Phone:540-598-9261
Mailing Address - Fax:
Practice Address - Street 1:3533 FRANKLIN RD SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-2201
Practice Address - Country:US
Practice Address - Phone:540-981-9321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206641183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist