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Organization
KENNETH SAMUEL GLOVER II
Active
Organization
KENNETH SAMUEL GLOVER II
Active
Other names
Ken Glover Drug
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH SAMUEL GLOVER II RPH (OWNER)
(205) 648-9918
Entity
Organization
Contact information
Practice address
27 MIDWAY PLAZA, DORA, AL 35062
(205) 648-9918
(205) 648-9644
Mailing address
2371 HWY 78, DORA, AL 35062
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
105923
AL
332BX2000X
Oxygen Equipment & Supplies (DME)
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009306540
—
AL
05
—
100002526
—
AL
01
—
510-50307
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
Enumeration date
09/20/2006
Last updated
02/23/2023
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