Michael Alexander Glen, R.PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH60216257 Issued in WA

Practice address

Haggen Food and Pharmacy
1815 Main Street
Ferndale, WA 98248

Phone

(360) 380-7210

Fax

(360) 380-7228

NPI assigned

Mar 17, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1770724965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HAGGEN FOOD AND PHARMACY",
            "address_2": "1815 MAIN STREET",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "98248",
            "telephone_number": "360-380-7210",
            "fax_number": "360-380-7228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HAGGEN FOOD AND PHARMACY",
            "address_2": "1815 MAIN STREET",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "98248",
            "telephone_number": "360-380-7210",
            "fax_number": "360-380-7228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEN",
        "first_name": "MICHAEL",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-17",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "51983",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60216257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Ferndale, WA
• Providers in Ferndale, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; 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.