Provider Demographics
NPI:1902039720
Name:BLANCHARD, KIMBERLY M (PHARMD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:M
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:BARBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:212 CORINTH CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ROSE HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28458-8319
Mailing Address - Country:US
Mailing Address - Phone:910-289-4271
Mailing Address - Fax:910-289-3880
Practice Address - Street 1:110 SOUTH SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:ROSE HILL
Practice Address - State:NC
Practice Address - Zip Code:28458
Practice Address - Country:US
Practice Address - Phone:910-289-4271
Practice Address - Fax:910-289-3880
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15951183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist