# KENNETH SAMUEL GLOVER II

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ken Glover Drug
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548367774
- **Authorized official:** KENNETH SAMUEL GLOVER II RPH (OWNER)
- **Authorized official phone:** (205) 648-9918

## Contact information

- **Practice address:** 27 MIDWAY PLAZA, DORA, AL 35062
- **Practice address phone:** (205) 648-9918
- **Practice address fax:** (205) 648-9644
- **Mailing address:** 2371 HWY 78, DORA, AL 35062

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | 105923 | AL | — |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 02/23/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 009306540 | — | AL |
| 05 | — | 100002526 | — | AL |
| 01 | — | 510-50307 | BLUE CROSS BLUE SHIELD OF ALABAMA | AL |