DR. BLAKE MARK LORD (NPI# 1801105291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801105291 |
| Entity Type | Individual |
| Full Name | DR. BLAKE MARK LORD |
| Credential | PHARMD |
| Practice Address |
5339 Old Highway 5 Woodstock GA 30188-2431 |
| Mailing Address |
625 Knights Bridge Dr Canton GA 30115-5215 |
| Practice Telephone | 7709246411 |
| Enumeration Date | 2010-10-01 |
| Last Update Date | 2014-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 025563 | GA | Pharmacy Service Providers |
| Street Address |
5339 OLD HIGHWAY 5 |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30188-2431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437183241 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 5339 Old Highway 5, Woodstock, GA 30188-2431 | 2006-07-10 |
| 1528690955 | Lauren Nicole Bryant | Pharmacist | 5339 Old Highway 5, Woodstock, GA 30188-2431 | 2020-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730715814 | Tyler Rose | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 116 South Mill Creek Court, Woodstock, GA 30188 | 2020-03-20 |
| 1881224897 | Dr. Tom LLC | Clinic/Center | 5431 Old Highway 5 Ste 206, Holly Springs, GA 30188 | 2020-01-17 |
| 1467090175 | Stacey Robin Hill | Dietitian, Registered | 210 Mcaffee St, Street Address 2, Woodstock, GA 30188 | 2019-12-12 |
| 1326681784 | Margo Vanderveen | Massage Therapist | 605 Old Hickory Road, Woodstock, GA 30188 | 2019-10-17 |
| 1275093437 | Rebekah Ruth Tchouta | Social Worker | 5166 Shotwell St, Woodstock, GA 30188 | 2019-03-23 |
| 1205395829 | Angela M Graves | Behavior Technician | 3229 S Cherokee Ln Ste 1400, Woodstock, GA 30188 | 2019-03-13 |
| 1396233391 | Costco Wholesale Corporation | Hearing Aid Equipment | 113 Lincoln Street, Woodstock, GA 30188 | 2018-04-25 |
| 1659878080 | Alexis K. Brown | Counselor | 3380 Trickum Rd., Bldg 700, Woodstock, GA 30188 | 2018-04-11 |
| 1427555440 | Lisa Marie Anthony | Specialist/Technologist | 400 Arnold Mill Rd, Woodstock, GA 30188 | 2018-04-06 |
| 1497254122 | J.a.h. Enterprises, LLC | Audiologist | 12195 Hwy. 92, Suite 114-325, Woodstock, GA 30188 | 2018-02-08 |
| Find all providers in zip 30188 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780283754 | Chuck Page | Pharmacist | 102 Woodside Pl, Woodstock, GA 30188-2369 | 2020-10-21 |
| 1598364648 | James Agler | Pharmacist | 400 Unicoi Ct, Woodstock, GA 30188-3125 | 2020-10-20 |
| 1801494356 | Susan Iruku | Pharmacist | 12050 Ga-92 #112, Woodstock, GA 30189 | 2020-10-15 |
| 1720686470 | Vanessa W Todd | Pharmacist | 536 Fairway Dr, Woodstock, GA 30189-6197 | 2020-10-14 |
| 1265946156 | Joseph Peter Stroh IIi | Pharmacist | 604 Watersedge Way, Woodstock, GA 30188-5449 | 2017-11-30 |
| 1801341912 | Devaki Patel | Pharmacist | 2106 Bexley Dr, Woodstock, MD 21163-1423 | 2016-08-18 |
| 1467844860 | Ashish Patel | Pharmacist | 10423 Popkins Ct, Woodstock, MD 21163-1316 | 2015-02-23 |
| 1598156556 | Jessica A Welker | Pharmacist | 718 Cedar Creek Way, Woodstock, GA 30189-5139 | 2015-02-12 |
| 1518398601 | Ellen Pulawski | Pharmacist | 350 New Sweden Rd, Woodstock, CT 06281-3218 | 2013-11-27 |
| 1245577212 | Charles Clifton Lee | Pharmacist | 1824 Hardman Ln, Woodstock, GA 30188-3103 | 2013-01-11 |
| Find all providers in WOODSTOCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.