Provider Demographics
NPI:1740482140
Name:GLINSEY, PHILIA C
Entity type:Individual
Prefix:MS
First Name:PHILIA
Middle Name:C
Last Name:GLINSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5933 BAXTER DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-3360
Mailing Address - Country:US
Mailing Address - Phone:601-957-8445
Mailing Address - Fax:
Practice Address - Street 1:771 HIGHWAY 98 BYP
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MS
Practice Address - Zip Code:39429-8256
Practice Address - Country:US
Practice Address - Phone:601-736-7799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-08437183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist