Provider Demographics
NPI:1669749230
Name:INMAN, GLENN (RPH)
Entity type:Individual
Prefix:
First Name:GLENN
Middle Name:
Last Name:INMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:GLENN
Other - Middle Name:
Other - Last Name:INMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:3720 BOILING SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-5716
Mailing Address - Country:US
Mailing Address - Phone:864-814-2388
Mailing Address - Fax:864-578-4139
Practice Address - Street 1:3720 BOILING SPRINGS RD
Practice Address - Street 2:
Practice Address - City:BOILING SPRINGS
Practice Address - State:SC
Practice Address - Zip Code:29316-5716
Practice Address - Country:US
Practice Address - Phone:864-814-2388
Practice Address - Fax:864-578-4139
Is Sole Proprietor?:No
Enumeration Date:2011-11-25
Last Update Date:2011-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5716183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist