Provider Demographics
NPI:1962788398
Name:BOBLIT, JAMES L (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:L
Last Name:BOBLIT
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 1:1805 BRADY STREET
Mailing Address - Street 2:
Mailing Address - City:DAVENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52803
Mailing Address - Country:US
Mailing Address - Phone:563-355-0986
Mailing Address - Fax:
Practice Address - Street 1:1805 BRADY ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-4729
Practice Address - Country:US
Practice Address - Phone:563-322-5933
Practice Address - Fax:563-322-3850
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA14323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist