Provider Demographics
NPI:1437154945
Name:GLASCOCK, GALE E (RPH)
Entity Type:Individual
Prefix:MR
First Name:GALE
Middle Name:E
Last Name:GLASCOCK
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 1:50 BISCAYNE DR NW
Mailing Address - Street 2:UNIT 2114
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1041
Mailing Address - Country:US
Mailing Address - Phone:404-352-2724
Mailing Address - Fax:
Practice Address - Street 1:50 BISCAYNE DR NW
Practice Address - Street 2:UNIT 2114
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1041
Practice Address - Country:US
Practice Address - Phone:404-352-2724
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH015161183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist