Glander Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

855742 Issued in WI

Legal business name

GLANDER INC

Practice address

3529 Superior Ave
Sheboygan, WI 53081-1865

Phone

(920) 459-2755

Fax

(920) 803-7519

NPI assigned

Jun 20, 2006

Organization subpart

No

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

Authorized official

Name

Robert Bouche, RPH

Title

Pres

Phone

(920) 459-2755

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• GLANDER PRESCRIPTIONS PLUS Doing business as

Medicare fee-for-service enrollment

Enrolled in WI2 enrollments

Enrollment records 2

Locations

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667174400000",
    "number": "1851336093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3529 SUPERIOR AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811865",
            "telephone_number": "920-459-2755",
            "fax_number": "920-803-7519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3529 SUPERIOR AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811865",
            "telephone_number": "920-459-2755",
            "fax_number": "920-803-7519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLANDER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A",
        "authorized_official_last_name": "BOUCHE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "920-459-2755",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "855742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2114842",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33158600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLANDER PRESCRIPTIONS PLUS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Casey Girdaukas
• Dione Marie Gisch, LPC
• Brian Giuliani, DC
• Scott T Glaeser, MD
• Glander Inc
• Alexandra C Glasscock, MD
• Amy Claire Glewen, PT
• Amy Goebel, PT
• Daniel Ross Goeckermann, DDS
• Golden Harbor, LLC

• Community/Retail Pharmacy in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.