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Contact Information

ROOSEVELT A BLYE JR, PHARM.D.
200 WEST RAILROAD STREET SUITE B
RITE AID
LONG BEACH, MS39560-2269
 Phone: 228-864-0334
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacist

183500000X
Indicates primary specialty

NPI Profile & details for ROOSEVELT A BLYE JR · (Male)

NPI Number 1780974238
Status Active
Credentials PHARM.D. (Doctor of Pharmacy)
Entity Individual
Enumeration date 04/18/2011
Last updated 04/18/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • MS License # 09535
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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