Active NPI
Mary Anne Glanville, PHARMD
- Pharmacist
- Oakland, CA
National Provider Identifier
1386178903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 44099
- Practice address
- 175 41St St
Oakland, CA 94611-5206 - Phone
- (510) 658-3496
- Fax
- (510) 658-0772
- NPI assigned
- Apr 20, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 44099 | CA | Primary |
Addresses
Primary practice location
175 41St St
Oakland, CA 94611-5206
Mailing address
175 41St St
Oakland, CA 94611-5206
Phone (510) 658-3496
Other names 1
- Mary Anne Kundert
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44099 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Stores California LLC | Past | Accepting new patients | |
| Longs Drug Store California LLC | Past | 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": "1492646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492646400000",
"number": "1386178903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 41ST ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115206",
"telephone_number": "510-658-3496",
"fax_number": "510-658-0772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 41ST ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115206",
"telephone_number": "510-658-3496",
"fax_number": "510-658-0772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLANVILLE",
"first_name": "MARY",
"middle_name": "ANNE",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-20",
"last_updated": "2017-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "44099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "KUNDERT",
"middle_name": "ANNE",
"credential": "PHARMD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.