Glenn Borden

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS27542 Issued in FL

Practice address

4802 NW 2ND Ave
Boca Raton, FL 33431-4173

Phone

(561) 241-7711

Fax

(561) 241-7717

NPI assigned

Apr 8, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Boca Raton Pharmacy, Inc

  dba Specialty Care Pharmacy

  • Community/Retail Pharmacy
  • Boca Raton, FL
  • NPI 1407277056
  NPD (past)

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1942889654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21321 ROCK RIDGE DR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334284876",
            "telephone_number": "561-706-7803",
            "fax_number": "561-241-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 NW 2ND AVE",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314173",
            "telephone_number": "561-241-7711",
            "fax_number": "561-241-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDEN",
        "first_name": "GLENN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS27542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84-2217583",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Makenna Rebekah Boose, DPT
• Boost Care Agency, LLC
• Taryn Renee Booth
• Brittany Borbely, PA-C
• Zachary Bordeau
• Lamar Zapata Borden, AU. D.
• Serena Marie Bordes, DOM LAC
• Lauro Borges
• Maria Juliana Borja Angulo, M.D.
• Carol Ann Borkowski, AM REGISTRY OF RADIO

• Pharmacist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.