Provider Demographics
NPI:1609482611
Name:GLADES HOLDING GROUP
Entity Type:Organization
Organization Name:GLADES HOLDING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROPSPIERRE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:305-469-5463
Mailing Address - Street 1:6005 DEL LAGO CIR APT 101
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33313-6302
Mailing Address - Country:US
Mailing Address - Phone:305-469-5463
Mailing Address - Fax:
Practice Address - Street 1:1417 NW AVENUE L STE 3
Practice Address - Street 2:
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-1780
Practice Address - Country:US
Practice Address - Phone:305-469-5463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty