GLENDALE PRESCRIPTION CENTER INC (NPI# 1114960994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114960994 |
| Entity Type | Organization |
| Organization Name | GLENDALE PRESCRIPTION CENTER INC |
| Other Organization Name | MD CUSTOM RX |
| Practice Address |
5322 N Port Washington Rd Glendale WI 53217-4913 |
| Practice Telephone | 4149679248 |
| Practice Fax Number | 4149679548 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MONICA MARIE ZATARSKI (OWNER PRESIDENT) |
| Authorized Official Telephone | 4149679248 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
8506042 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 5128738 | 01 |
| Other Name | Type Code |
|---|---|
| MD CUSTOM RX | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598760639 | Glendale Prescription Center Inc | Pharmacy | 7601 Castor Ave, Ste 100 Lobby, Philadelphia, PA 19152-4026 | 2005-06-16 |
| Street Address |
5322 N PORT WASHINGTON RD |
| City | GLENDALE |
| State | WI |
| Zip Code | 53217-4913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740535756 | Daniel E Carriger | Audiologist-Hearing Aid Fitter | 5322 N Port Washington Rd, Glendale, WI 53217-4913 | 2012-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922632587 | Jasmine Dockery | Pharmacist | 5400 N Port Washington, Glendale, WI 53217 | 2020-02-23 |
| 1174017339 | North Lakes Nursing Home Health Care Agency LLC | Home Health | 225 E Fairmount Ave, Milwaukee, WI 53217 | 2018-06-20 |
| 1083140289 | Miriah Ann King, Ms, Lpc | Counselor | 7805 North Boyd Way, Fox Point, WI 53217 | 2017-05-08 |
| 1245783067 | Lakesha L Jones | Counselor | 5235 N Ironwood Rd, Glendale, WI 53217 | 2016-07-28 |
| 1750783312 | Ibrahim S Abouzeid | Specialist/Technologist, Other | 333 W Brown Deer Road, #240, Milwaukee, WI 53217 | 2014-09-25 |
| 1255733598 | Victoria Gorodetsky | Pharmacist | 229 W Indian Creek Ct, Milwaukee, WI 53217 | 2014-09-18 |
| 1174800049 | John Herman Esser | Internal Medicine | 1050 W Acacia Rd, Milwaukee, WI 53217 | 2011-11-07 |
| 1710298351 | Leann M Harman | Physical Therapist | 5333 N Port Washington Rd Ste B, Glendale, WI 53217 | 2010-06-29 |
| 1306012455 | Emily Marie Gallagher | Speech-Language Pathologist | 6700 N. Port Washington Road, Milwaukee, WI 53217 | 2008-05-07 |
| 1164625455 | Mary Catherine Enderlin | Psychologist | 6110 N Port Washington Road, The Cambridge Group, Glendale, WI 53217 | 2007-06-06 |
| Find all providers in zip 53217 | ||||
| Taxonomy Code | 3336S0011X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Specialty Pharmacy |
| A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| 1386865269 | Ritt Medical, Inc. | Pharmacy | 6283 W Lone Cactus Dr, Glendale, AZ 85308-6304 | 2007-05-01 |
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| 1154812527 | Triple S R Pharmacy Inc | Pharmacy | 330 N Brand Blvd Ste 155, Glendale, CA 91203-2324 | 2018-05-22 |
| 1275930638 | Triple S R Pharmacy Inc | Pharmacy | 330 N Brand Blvd, Suite 155, Glendale, CA 91203-2308 | 2014-12-01 |
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| 1700974409 | Health Care Pharmacies, Inc | Pharmacy | 252 State Highway 70 E, Saint Germain, WI 54558-8800 | 2006-10-10 |
| 1730121039 | Md Group II LLC | Pharmacy | 1101 Hwy 69 Ste 7, New Glarus, WI 53574 | 2006-06-12 |
| 1992751143 | Corner Drug Store, Inc | Pharmacy | 316 W Spring St Ste 6, Dodgeville, WI 53533-1300 | 2006-05-26 |
| 1912416991 | Algoma Hometown Pharmacy LLC | Pharmacy | 801 Jefferson St, Algoma, WI 54201-1733 | 2017-09-22 |
| 1841739166 | Hemophilia Outreach Center | Pharmacy | 2060 Bellevue St, Green Bay, WI 54311-5622 | 2017-02-20 |
| 1093884207 | Apria Healthcare, Inc. | Pharmacy | 5345 S Moorland Rd, New Berlin, WI 53151-7925 | 2006-11-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.