Active NPI
Lloyd E. Glynn, R.PH.
- Pharmacist
- Arbor Vitae, WI
National Provider Identifier
1245344779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9546-40
- Practice address
- 2777 Downda Rd
Arbor Vitae, WI 54568-9449 - Phone
- (715) 356-6696
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9546040 | WI | |
| Pharmacist | 183500000X | 9546-40 | WI | Primary |
Addresses
Primary practice location
2777 Downda Rd
Arbor Vitae, WI 54568-9449
Mailing address
2777 Downda Rd
Arbor Vitae, WI 54568-9449
Phone (715) 356-6696
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9546-40 | WI | MD | Pharmacist |
| 9546040 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583798400000",
"number": "1245344779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2777 DOWNDA RD",
"city": "ARBOR VITAE",
"state": "WI",
"postal_code": "545689449",
"telephone_number": "715-356-6696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2777 DOWNDA RD",
"city": "ARBOR VITAE",
"state": "WI",
"postal_code": "545689449",
"telephone_number": "715-356-6696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLYNN",
"first_name": "LLOYD",
"middle_name": "E.",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2020-03-10",
"certification_date": "2020-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "9546040",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "9546-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arbor Vitae, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.