Organization Active NPI

Glendale Pharmacy, LLC

  • Long Term Care Pharmacy
  • Newport News, VA
National Provider Identifier
1811646805
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
GLENDALE PHARMACY, LLC
Practice address
12444 Warwick Blvd
Newport News, VA 23606-3042
Phone
(757) 595-3355
Fax
(757) 596-1863
NPI assigned
Mar 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Authorized official

Name
Armya R MaraeNPI 1235721309
Title
Pic
Phone
(757) 595-3355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

12444 Warwick Blvd
Newport News, VA 23606-3042

Mailing address

12444 Warwick Blvd
Newport News, VA 23606-3042
Phone (757) 595-3355

National Provider Directory

National Provider Directory
Tax ID family
Glendale Pharmacy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12444 Warwick Blvd
Newport News, VA 23606
Phone (757) 595-3355

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647820800000",
    "number": "1811646805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12444 WARWICK BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063042",
            "telephone_number": "757-595-3355",
            "fax_number": "757-596-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12444 WARWICK BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063042",
            "telephone_number": "757-595-3355",
            "fax_number": "757-596-1863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A",
        "authorized_official_last_name": "MARAE",
        "authorized_official_first_name": "ARMYA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "757-595-3355"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.