| NPI | 1760974547 |
|---|---|
| Doing Business As | GLADE LTC |
| Entity Type | Organization |
| Authorized Contact | SETH JENNINGS Owner 276-776-1920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: VA 0201004205) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2024-05-20 |