Individual
DR. GLENN J GREEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
12 WESTBANK EXPY, GRETNA, LA 70053-3647
(504) 509-5208
Mailing address
12 WESTBANK EXPY, GRETNA, LA 70053-3647
(504) 509-5208
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17753
LA
183500000X
Pharmacist
45045
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1896870
—
LA
01
—
MA.000101
MEDICATION ADMINISTRATION
LA
Enumeration date
03/10/2010
Last updated
08/22/2025
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