Healthcare Provider Details

I. General information

NPI: 1235668906
Provider Name (Legal Business Name): GLORY PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2017
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9675 MONTE VISTA AVE STE A
MONTCLAIR CA
91763-2213
US

IV. Provider business mailing address

9675 MONTE VISTA AVE STE A
MONTCLAIR CA
91763-2213
US

V. Phone/Fax

Practice location:
  • Phone: 626-234-3186
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY55669
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NORA ISKANDAR
Title or Position: SECRETARY
Credential:
Phone: 909-542-9365