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Dr. Roosevelt Alonzo Blye Jr., pharm.d

Pharmacist in Long Beach, MS. Individual provider (NPI-1).

NPI number1780974238
StatusActive
Last updated in NPPESApr 18, 2011

Details

NPI
1780974238
Entity type
Individual (NPI-1)
Name
Dr. Roosevelt Alonzo Blye Jr.
Credential
pharm.d
Sex
Male
Sole proprietor
No
Enumeration date
Apr 18, 2011
Last updated
Apr 18, 2011

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183500000X Pharmacist09535MSYes

Practice location

200 West Railroad Street Suite B
Rite Aid
Long Beach, MS 39560-2269

Phone 228-864-0334

Mailing address

1593 Rachel Drive
Biloxi, MS 39532

Phone 228-392-0112

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Other Pharmacist providers in Long Beach, MS

All 14 Pharmacist providers in Long Beach · All 190 providers in Long Beach

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