Healthcare Provider Details

I. General information

NPI: 1073443917
Provider Name (Legal Business Name): GLND MEDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 GLENMORE AVE
BROOKLYN NY
11207-3709
US

IV. Provider business mailing address

559 GLENMORE AVE
BROOKLYN NY
11207-3709
US

V. Phone/Fax

Practice location:
  • Phone: 718-489-3866
  • Fax: 718-489-3865
Mailing address:
  • Phone: 718-489-3866
  • Fax: 718-489-3865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GAVRIEL YAKUBOV
Title or Position: OWNER
Credential:
Phone: 718-489-3866