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General NPI Number Information
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NPI Number | 1669656179
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Entity Type | Organization
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Legal Business Name | GLADE PHARMACY LLC
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Dates
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Enumeration Date | 12/19/2007
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 33472 LEE HWY
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City | GLADE SPRING
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State | VA
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Zip | 24340-5100
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Country | US
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Telephone | 276-429-2004
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Fax | 276-429-2009
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Provider Business Mailing Address
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Address Line | 33472 LEE HWY
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City | GLADE SPRING
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State | VA
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Zip | 24340-5100
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Country | US
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Telephone | 276-429-2004
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Fax | 276-429-2009
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Authorized Official
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Title or Position | PIC
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Name | JEFFREY TAYLOR
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Credential | PHARM D
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Telephone | 276-429-2004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State |
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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 | 4489
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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