Provider Demographics
NPI:1770698110
Name:BLANKINSHIP, KIM EDWARD (RPH)
Entity type:Individual
Prefix:MR
First Name:KIM
Middle Name:EDWARD
Last Name:BLANKINSHIP
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 CARSON RD
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-4538
Mailing Address - Country:US
Mailing Address - Phone:256-446-6397
Mailing Address - Fax:
Practice Address - Street 1:11601 HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:AL
Practice Address - Zip Code:35648-3249
Practice Address - Country:US
Practice Address - Phone:256-229-5550
Practice Address - Fax:256-229-5078
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10076183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist