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DERYCK BLAKE RPH
NPI 1568067114
Pharmacist in Lithonia, GA

Active since December 02, 2020
5401 FAIRINGTON RD, LITHONIA, GA 30038(770) 593-4998 Get Directions Write a Review

NPPES record last updated: December 2, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Deryck Blake Rph NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERYCK BLAKE RPH (NPI 1568067114) is an individual pharmacist in Lithonia, Georgia, licensed in Georgia (RPH016053) and active in the NPI registry since December 2020.

NPPES Registry Identity

NPI1568067114
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameDERYCK BLAKECredential: RPH
Location Address5401 FAIRINGTON RDLithonia, GA 30038-5113
Mailing Address882 Heritage PlDecatur, GA 30033-4104 · (678) 776-4569
Phone(770) 593-4998
Sole ProprietorNo
Enumeration DateDecember 2, 2020
NPPES CertifiedDecember 2, 2020
✔ NPI 1568067114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License✔ Licensed in GA · RPH016053
Definition
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.
5401 FAIRINGTON RD, Lithonia, GA 30038
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Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GARY AUSTIN FREEMAN
Pharmacist
5401 FAIRINGTON RD
LITHONIA, GA 30038
Dekalb County (770) 593-4998
MS. KEYONNA MANNING CPHT
Pharmacy Technician
5401 FAIRINGTON RD
LITHONIA, GA 30038
Dekalb County (404) 719-6140
DR. COREY RICHARD SLACKS
Pharmacist
5401 FAIRINGTON RD
LITHONIA, GA 30038
Dekalb County (770) 598-4998
LITHONIA FAMILY EYE CARE LLC
Optometrist
5401 FAIRINGTON RD
LITHONIA, GA 30038
Dekalb County (770) 808-2772
WAL-MART STORES EAST LP
Pharmacy (Community/Retail Pharmacy)
5401 FAIRINGTON RD
LITHONIA, GA 30038
Dekalb County (770) 593-4998
WAL-MART STORES EAST, LP
Eyewear Supplier
5401 FAIRINGTON RD
LITHONIA, GA 30038
Dekalb County (770) 593-3540

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deryck Blake's NPI number?

The NPI number for Deryck Blake is 1568067114. It was assigned to this individual provider in the NPPES registry on December 2, 2020.

Where is Deryck Blake located?

Deryck Blake practices at 5401 Fairington Rd, Lithonia, GA 30038. The listed phone number is (770) 593-4998.

What is Deryck Blake's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Deryck Blake was last updated on December 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.