Glendale Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

GLENDALE PHARMACY LLC

Practice address

4203 Gardendale St Ste 223C
San Antonio, TX 78229-3177

Phone

(210) 617-5507

Fax

(210) 617-4575

NPI assigned

Jun 23, 2021

Organization subpart

No

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

Authorized official

Name

Gilbert GitauNPI 1033522909

Title

Managing Officer

Phone

(302) 981-6163

Specialties & licenses 2

Addresses

Other names 1

• LELA PHARMACY Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gilbert Gitau, PHAMD

  • Pharmacist
  • San Antonio, TX
  • NPI 1033522909
  NPD Authorized official

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626652800000",
    "number": "1205405248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 GARDENDALE ST STE 223C",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293177",
            "telephone_number": "210-617-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 GARDENDALE ST STE 223C",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293177",
            "telephone_number": "210-617-5507",
            "fax_number": "210-617-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A",
        "authorized_official_last_name": "GITAU",
        "authorized_official_first_name": "GILBERT",
        "authorized_official_title_or_position": "MANAGING OFFICER",
        "authorized_official_telephone_number": "302-981-6163"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LELA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul William Gleason IV
• Geoffrey Paul Glebus, DO
• David Michael Gleinser, MD
• Paul Francis Gleinser, LPC
• Glen Oaks Health Care Services LLC
• Angel Renee Glenn
• Namir Glenn
• Timother Glesener, DDS
• Jonathan Michael Glick, M.D
• Gordana Gligoric, MD

• Community/Retail Pharmacy in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.