Blake, Conrad James

Blake, Conrad James is an individual health care provider with primary practice located at 3515 Airway Dr Suite 210, Reno NV 89511-1849. He recently has only one registered license in Pharmacy Service Providers / Pharmacotherapy, which is considered as his primary health care specialty. Blake, Conrad James can be contacted via phone (775) 851-7788.

Contact Information

Primary practice address
3515 Airway Dr Suite 210 Reno NV 89511-1849
Fax: (775) 851-7788
Website:

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacotherapy 1835P1200X NV16076 Nevada

Profile Details

NPI number 1497741144
LBN Legal business name Blake, Conrad James
Credentials PHARMD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2005
Last updated Aug 2nd, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497741144 NPPES
Nevada Other NV16076 NV BOARD OF PHARMACY LIC

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