Organization
GLADE LTC, LLC
Active
Other names
Glade LTC
Organization subpart
No
Provider details
NPI number
Authorized official
SETH JENNINGS PHARMD (OWNER)
(276) 776-1920
Entity
Organization
Contact information
Practice address
305 FALLS DR NW, ABINGDON, VA 24210-8093
(276) 776-1920
(276) 776-1930
Mailing address
305 FALLS DR NW, ABINGDON, VA 24210-8093
(276) 776-1920
(276) 776-1930
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760974547
—
VA
Enumeration date
06/06/2018
Last updated
03/10/2025
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