Organization
GLANDER INC
Active
Other names
GLANDER PRESCRIPTIONS PLUS
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BOUCHE (PRESIDENT)
(920) 459-2755
Entity
Organization
Contact information
Practice address
3529 SUPERIOR AVE, SHEBOYGAN, WI 53081-1865
(920) 459-2755
(920) 803-7519
Mailing address
3529 SUPERIOR AVE, SHEBOYGAN, WI 53081-1865
(920) 459-2755
(920) 803-7519
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
855742
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2176009
PK
—
05
—
33158600
—
WI
Enumeration date
02/23/2018
Last updated
02/23/2018
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