Blaylock, Jared Andrew

Blaylock, Jared Andrew is an individual health care provider with primary practice located at 1 W Edwardsville Rd , Wood River IL 62095-1261. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Blaylock, Jared Andrew can be contacted via phone (618) 254-3610.

Contact Information

Primary practice address
1 W Edwardsville Rd Wood River IL 62095-1261
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 051303330 Illinois
Pharmacy Service Providers / Pharmacist 183500000X 2020023097 Missouri

Profile Details

NPI number 1770187783
LBN Legal business name Blaylock, Jared Andrew
Credentials PHARMD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2020
Last updated Feb 17th, 2022 - about 2 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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