Individual provider Active NPI

Demetria Latrice Glover

  • Pharmacist
  • Baltimore, MD
National Provider Identifier
1093523557
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
30209 Issued in MD
Practice address
1801 Whetstone Way
Baltimore, MD 21230-5199
Phone
(410) 528-1244
Fax
(410) 528-9293
NPI assigned
Dec 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 30209 MD Primary

Addresses

Primary practice location

1801 Whetstone Way
Baltimore, MD 21230-5199

Mailing address

8519 River Park Rd
Bowie, MD 20715-3376
Phone (803) 420-0498

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30209MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Harris Teeter LLC PastSince Jan 5, 2025 Accepting new patients
Harris Teeter, LLC PastSince Jan 5, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1093523557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8519 RIVER PARK RD",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207153376",
            "telephone_number": "803-420-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 WHETSTONE WAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212305199",
            "telephone_number": "410-528-1244",
            "fax_number": "410-528-9293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "DEMETRIA",
        "middle_name": "LATRICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "30209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.