Provider Demographics
NPI:1326034257
Name:GLESSNER, CHARLOTTE (R PH)
Entity Type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:
Last Name:GLESSNER
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MC SHERRYSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17344-1800
Mailing Address - Country:US
Mailing Address - Phone:717-630-2773
Mailing Address - Fax:717-630-2824
Practice Address - Street 1:10 S 6TH ST
Practice Address - Street 2:
Practice Address - City:MC SHERRYSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17344-1800
Practice Address - Country:US
Practice Address - Phone:717-630-2773
Practice Address - Fax:717-630-2824
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP025689L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1281461Medicaid
0278910001Medicare ID - Type Unspecified