Individual provider Active NPI

Glendon Earl Gravlee

  • Pharmacist
  • Parrish, AL
National Provider Identifier
1528118932
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
9125 Issued in AL
Practice address
6456 Al Hwy 269
Parrish, AL 35580
Phone
(205) 648-9945
Fax
(205) 648-9993
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 9125 AL Primary

Addresses

Primary practice location

6456 Al Hwy 269
Parrish, AL 35580

Mailing address

2408 Woodley Dr
Jasper, AL 35504-9456

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

State licenses

LicenseStateTypeSpecialty
9125ALMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1528118932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 WOODLEY DR",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355049456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6456 AL HWY 269",
            "city": "PARRISH",
            "state": "AL",
            "postal_code": "35580",
            "telephone_number": "205-648-9945",
            "fax_number": "205-648-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVLEE",
        "first_name": "GLENDON",
        "middle_name": "EARL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "9125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parrish, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.