Provider Demographics
NPI:1598083180
Name:GARVER, GLENN EUGENE (RPH)
Entity Type:Individual
Prefix:MR
First Name:GLENN
Middle Name:EUGENE
Last Name:GARVER
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 1:18 BELVEDERE DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-6131
Mailing Address - Country:US
Mailing Address - Phone:717-691-7916
Mailing Address - Fax:
Practice Address - Street 1:4415 LEWIS RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-2541
Practice Address - Country:US
Practice Address - Phone:800-861-1735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-07
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP026927L183500000X
NJ28RI02896900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist