Active NPI
Glenn J Green Jr., PHARMD
- Pharmacist
- Gretna, LA
National Provider Identifier
1497078042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17753
- Practice address
- 12 Westbank Expy
Gretna, LA 70053-3647 - Phone
- (504) 509-5208
- NPI assigned
- Mar 10, 2010
- Sex
- Male
- Sole proprietor
- No
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 | 45045 | TX | |
| Pharmacist | 183500000X | 17753 | LA | Primary |
Addresses
Primary practice location
12 Westbank Expy
Gretna, LA 70053-3647
Mailing address
12 Westbank Expy
Gretna, LA 70053-3647
Phone (504) 509-5208
Other practice location 1
4700 wichers dr
suite 303
marrero, LA 70072-3041
Phone (504) 390-9135
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA.000101 | Other | LA | MEDICATION ADMINISTRATION |
| 1896870 | Medicaid | LA |
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 |
|---|---|---|---|
| 17753 | LA | MD | Social Worker |
| 45045 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755820800000",
"number": "1497078042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 WESTBANK EXPY",
"city": "GRETNA",
"state": "LA",
"postal_code": "700533647",
"telephone_number": "504-509-5208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 WESTBANK EXPY",
"city": "GRETNA",
"state": "LA",
"postal_code": "700533647",
"telephone_number": "504-509-5208"
}
],
"practiceLocations": [
{
"address_1": "4700 wichers dr",
"address_2": "suite 303",
"address_purpose": "LOCATION",
"city": "marrero",
"state": "LA",
"postal_code": "700723041",
"country_code": "US",
"telephone_number": "504-390-9135",
"fax_number": "504-341-4140",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GREEN",
"first_name": "GLENN",
"middle_name": "J",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-10",
"last_updated": "2025-08-22",
"certification_date": "2025-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "45045",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "17753",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICATION ADMINISTRATION",
"identifier": "MA.000101",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1896870",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gretna, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.