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General NPI Number Information
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NPI Number | 1023218138
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Entity Type | Organization
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Legal Business Name | R P GLIDDEN INC
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 139 N GRAND ST
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City | SCHOOLCRAFT
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State | MI
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Zip | 49087-5111
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Country | US
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Telephone | 269-679-2008
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Fax | 269-679-2722
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Provider Business Mailing Address
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Address Line | PO BOX 399
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City | SCHOOLCRAFT
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State | MI
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Zip | 49087-0399
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Country | US
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Telephone | 269-679-2008
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Fax | 269-679-2722
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | JULIANN BRADISH
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Credential | PHARMD
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Telephone | 219-545-2445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 5301008669
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301008669
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License Number State | MI
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