Provider Demographics
NPI:1942547880
Name:MENDEZ-GREENE, GLORIA MARGARET (PHARM D)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:MARGARET
Last Name:MENDEZ-GREENE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12070 COUNTY LINE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35756-2000
Mailing Address - Country:US
Mailing Address - Phone:256-230-2631
Mailing Address - Fax:256-230-2636
Practice Address - Street 1:12070 COUNTY LINE RD
Practice Address - Street 2:SUITE C
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35756-2000
Practice Address - Country:US
Practice Address - Phone:256-230-2631
Practice Address - Fax:256-230-2636
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15969183500000X
CO18347183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist