Provider Demographics
NPI:1659051175
Name:BLANCHARD, DAVID RANDALL (RPH, CPP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:RANDALL
Last Name:BLANCHARD
Suffix:
Gender:M
Credentials:RPH, CPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 PARKWAY OFFICE CT STE 200
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-0002
Mailing Address - Country:US
Mailing Address - Phone:984-974-1483
Mailing Address - Fax:984-974-2151
Practice Address - Street 1:150 PARKWAY OFFICE CT STE 200
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-0002
Practice Address - Country:US
Practice Address - Phone:984-974-1483
Practice Address - Fax:984-974-2151
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7004511835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology