Healthcare Provider Details

I. General information

NPI: 1700540366
Provider Name (Legal Business Name): GLADES DRUGS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2021
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 BROKEN SOUND PKWY NW
BOCA RATON FL
33487-3501
US

IV. Provider business mailing address

733 RICKEY JACKSON BLVD
PAHOKEE FL
33476-2500
US

V. Phone/Fax

Practice location:
  • Phone: 561-231-3131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State

VIII. Authorized Official

Name: MS. JAMIA TILLMAN
Title or Position: PRESIDENT
Credential:
Phone: 561-402-6762