Provider Demographics
NPI:1417553603
Name:TURNER, GLENN (RPH)
Entity Type:Individual
Prefix:
First Name:GLENN
Middle Name:
Last Name:TURNER
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 1:1455 S GUIGNARD DR
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-7479
Mailing Address - Country:US
Mailing Address - Phone:803-778-5758
Mailing Address - Fax:803-778-5763
Practice Address - Street 1:1455 S GUIGNARD DR
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-7479
Practice Address - Country:US
Practice Address - Phone:803-778-5758
Practice Address - Fax:803-778-5763
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist