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)
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
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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