Provider Demographics
NPI:1306190590
Name:GLODOWSKI, ROBERT DANIEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:DANIEL
Last Name:GLODOWSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 OLD CLEAR CREEK RD
Mailing Address - Street 2:ATTN PHARMACY
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89705-6853
Mailing Address - Country:US
Mailing Address - Phone:775-881-2502
Mailing Address - Fax:775-881-2509
Practice Address - Street 1:700 OLD CLEAR CREEK RD
Practice Address - Street 2:ATTN PHARMACY
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89705-6853
Practice Address - Country:US
Practice Address - Phone:775-881-2502
Practice Address - Fax:775-881-2509
Is Sole Proprietor?:No
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist