Glojoseli Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE010135 Issued in GA

Legal business name

GLOJOSELI INC

Doing business as

Open Gate Pharmacy 2

Practice address

1807 S Lumpkin Rd Ste C
Columbus, GA 31903-2794

Phone

(706) 940-0365

Fax

(706) 507-5267

NPI assigned

Mar 31, 2015

Organization subpart

No

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

Authorized official

Name

Mojisola Omobike Evbuomwan

Title

Owner

Phone

(706) 662-2400

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• OPEN GATE PHARMACY 2 Doing business as

Locations

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430956800000",
    "number": "1982099636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 10TH AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319011459",
            "telephone_number": "706-662-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 S LUMPKIN RD STE C",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319032794",
            "telephone_number": "706-940-0365",
            "fax_number": "706-507-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOJOSELI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-31",
        "last_updated": "2015-05-07",
        "status": "A",
        "authorized_official_last_name": "EVBUOMWAN",
        "authorized_official_first_name": "MOJISOLA",
        "authorized_official_middle_name": "OMOBIKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-662-2400"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2151114",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OPEN GATE PHARMACY 2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Petra S Glover, NP-C
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• Community/Retail Pharmacy in Columbus, GA
• Providers in Columbus, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2015; 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.