Provider Demographics
NPI:1831328483
Name:WOODCOCK, GLENNA ROSE (PHARMD)
Entity type:Individual
Prefix:
First Name:GLENNA
Middle Name:ROSE
Last Name:WOODCOCK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 CHRISTOPHER ST
Mailing Address - Street 2:CVS PHARMACY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-4236
Mailing Address - Country:US
Mailing Address - Phone:212-627-2662
Mailing Address - Fax:
Practice Address - Street 1:75 CHRISTOPHER ST
Practice Address - Street 2:CVS PHARMACY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-4236
Practice Address - Country:US
Practice Address - Phone:212-627-2662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-03
Last Update Date:2009-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052942183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist