Provider Demographics
NPI:1831316710
Name:BLANKENSHIP, CHESTER W (DPH)
Entity Type:Individual
Prefix:DR
First Name:CHESTER
Middle Name:W
Last Name:BLANKENSHIP
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 E WATAUGA AVE
Mailing Address - Street 2:BLANKENSHIP PHARMACY
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-4630
Mailing Address - Country:US
Mailing Address - Phone:423-926-4801
Mailing Address - Fax:
Practice Address - Street 1:222 E WATAUGA AVE
Practice Address - Street 2:BLANKENSHIP PHARMACY
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-4630
Practice Address - Country:US
Practice Address - Phone:423-926-4801
Practice Address - Fax:423-929-1381
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24751835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy