Individual provider Active NPI

Pamela Glemboski, RPH

  • Pharmacist
  • Agawam, MA
National Provider Identifier
1356419220
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19334 Issued in MA
Practice address
17 Springfield St
Agawam, MA 01001-1521
Phone
(413) 786-6060
Fax
(413) 789-3368
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19334 MA Primary
Pharmacist 183500000X 6350 CT

Addresses

Primary practice location

17 Springfield St
Agawam, MA 01001-1521

Mailing address

796 Suffield St
Suffield, CT 06078-2222
Phone (860) 668-2917

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

LicenseStateTypeSpecialty
19334MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1356419220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "796 SUFFIELD ST",
            "city": "SUFFIELD",
            "state": "CT",
            "postal_code": "060782222",
            "telephone_number": "860-668-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 SPRINGFIELD ST",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010011521",
            "telephone_number": "413-786-6060",
            "fax_number": "413-789-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEMBOSKI",
        "first_name": "PAMELA",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "19334",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "6350",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Agawam, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.