Organization Active NPI

Glades Drugs Inc.

  • Pharmacist
  • Boca Raton, FL
National Provider Identifier
1700540366
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
Legal business name
GLADES DRUGS INC.
Practice address
1095 Broken Sound Pkwy NW
Boca Raton, FL 33487-3501
Phone
(561) 231-3131
NPI assigned
Oct 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Authorized official

Name
Ms. Jamia Tillman
Title
President
Phone
(561) 402-6762

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X Primary

Addresses

Primary practice location

1095 Broken Sound Pkwy NW
Boca Raton, FL 33487-3501

Mailing address

733 Rickey Jackson Blvd
Pahokee, FL 33476-2500

Other identifiers 2

IdentifierTypeStateIssuer
613319331MedicaidCA
295061497MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Loose9k@icloud.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

1095 Broken Sound Pkwy NW
Boca Raton, FL 33487
Phone (561) 231-3131

NPI Registry JSON

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635379200000",
    "number": "1700540366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 RICKEY JACKSON BLVD",
            "city": "PAHOKEE",
            "state": "FL",
            "postal_code": "334762500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 BROKEN SOUND PKWY NW",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334873501",
            "telephone_number": "561-231-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADES DRUGS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A",
        "authorized_official_last_name": "TILLMAN",
        "authorized_official_first_name": "JAMIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-402-6762",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "613319331",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295061497",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Loose9k@icloud.com",
            "affiliation": "N",
            "endpointDescription": "Email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1095 Broken Sound Pkwy NW",
            "city": "Boca Raton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334873501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.