Glenwood Pharmacy, Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

2006CP Issued in ID

Legal business name

GLENWOOD PHARMACY, INC

Practice address

1105 Michigan Ave
Orofino, ID 83544-9005

Phone

(208) 476-5727

Fax

(208) 476-4045

NPI assigned

Jun 27, 2005

Last updated

Jul 15, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patricia PetersonNPI 1972643237

Title

President

Phone

(208) 476-5727

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patricia Peterson, R.PH.

  • Pharmacist
  • Orofino, ID
  • NPI 1972643237
  Authorized official Same address or phone

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373846400000",
    "number": "1386640001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 MICHIGAN AVE",
            "city": "OROFINO",
            "state": "ID",
            "postal_code": "835449005",
            "telephone_number": "208-476-5727",
            "fax_number": "208-476-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 MICHIGAN AVE",
            "city": "OROFINO",
            "state": "ID",
            "postal_code": "835449005",
            "telephone_number": "208-476-5727",
            "fax_number": "208-476-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENWOOD PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2013-07-15",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-476-5727"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "ID",
            "license": "2006CP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002501800",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002593600",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1303495",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelly Frances Frayser, MD
• Bryan A Garton, D.C.
• Gentle Family Dentistry, P.C.
• Jacqueline Gingerich, L.P.C
• Glenwood Pharmacy Inc (Riverside Pharmacy)
• Donald W Goetsch, PHARMACIST
• James Douglas Gray, DDS DENTIST
• Harper Chiropractic Clinic, Inc.
• Dennis Lee Harper, D.C.
• Curtis Jonathan Hartman, NP-C

• Pharmacy in Orofino, ID
• Providers in Orofino, ID by specialty
• Pharmacy in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; 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.