Mark Patrick Glenn, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

14328 Issued in OK

Practice address

3712 W Main St
Durant, OK 74701-4529

Phone

(580) 924-5112

Fax

(580) 924-4551

NPI assigned

Apr 5, 2022

Last updated

Apr 5, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mercy Hospital Ardmore

  • General Acute Care Hospital
  • Madill, OK
  • NPI 1871945162
  Authorized official Same address or phone
• Wal-Mart Stores East LP

  dba Walmart Pharmacy 10-0975

  • Community/Retail Pharmacy
  • Durant, OK
  • NPI 1417974544
  NPD (past)
• Wal-Mart Stores East, LP

  dba Walmart Pharmacy 10-2229

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1538800586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23049 RIGSBY RD",
            "city": "MADILL",
            "state": "OK",
            "postal_code": "734462301",
            "telephone_number": "405-205-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3712 W MAIN ST",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747014529",
            "telephone_number": "580-924-5112",
            "fax_number": "580-924-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "MARK",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "14328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikki Gill
• Sierra Gillard
• Stacy L Girdner
• Breanna Faye Gleason
• Heather Gleaton
• GLN Inc of Durant (Nichols Dollar Saver)
• Troy O'Neal Glover, CPRSS
• Zaylie Isabella Glover
• Teresa Golden
• Whitney Gonzales

• Pharmacist in Durant, OK
• Providers in Durant, OK by specialty
• Pharmacist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.