Provider Demographics
NPI:1831175736
Name:GLOWAC, ROBERT DENNIS JR (BS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:DENNIS
Last Name:GLOWAC
Suffix:JR
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1833 36TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-5927
Mailing Address - Country:US
Mailing Address - Phone:507-280-6618
Mailing Address - Fax:
Practice Address - Street 1:MAYO CLINIC PHARMACY, 21 2ND ST SW
Practice Address - Street 2:BRACKENRIDGE LL ROOM BK-B10A
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905-0001
Practice Address - Country:US
Practice Address - Phone:507-284-3014
Practice Address - Fax:507-284-5824
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN114835-6183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist