Provider Demographics
NPI:1598464216
Name:LAIRD, BLAINE JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BLAINE
Middle Name:
Last Name:LAIRD
Suffix:JR
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 1:258 W CORNER RD
Mailing Address - Street 2:
Mailing Address - City:CORSICA
Mailing Address - State:PA
Mailing Address - Zip Code:15829-1932
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1010 DELAFIELD RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215-1802
Practice Address - Country:US
Practice Address - Phone:412-822-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP457050183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist