# GLENDALE CLINIC PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093818429
- **Authorized official:** EMILE DALAL RPH (PHARMACIST OWNER)
- **Authorized official phone:** (414) 362-9560

## Contact information

- **Practice address:** 9233 N GREEN BAY RD, BROWN DEER, WI 53209
- **Practice address phone:** (414) 362-9560
- **Practice address fax:** (414) 270-8140
- **Mailing address:** 9233 N GREEN BAY RD, BROWN DEER, WI 53209
- **Mailing address phone:** (414) 362-9560
- **Mailing address fax:** (414) 270-8140

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 09/07/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 33143100 | — | WI |