=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972870772
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GAIL GLASGOW RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/22/2011
-----------------------------------------------------
Last Update Date | 11/22/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 220 E. LEWIS AND CLARK PARKWAY
-----------------------------------------------------
City | CLARKSVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47129
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-944-4466
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5010 BENT CREEK DR
-----------------------------------------------------
City | FLOYDS KNOBS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47119-9200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 26021332A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------