Provider Demographics
NPI:1104125921
Name:GLEMSER, CHERYL E (RPH)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:E
Last Name:GLEMSER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6257 N US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:PORT ST JOHN
Mailing Address - State:FL
Mailing Address - Zip Code:32927-4925
Mailing Address - Country:US
Mailing Address - Phone:321-633-8150
Mailing Address - Fax:321-633-6880
Practice Address - Street 1:6257 N US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:PORT ST JOHN
Practice Address - State:FL
Practice Address - Zip Code:32927-4925
Practice Address - Country:US
Practice Address - Phone:321-633-8150
Practice Address - Fax:321-633-6880
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS22842183500000X
TX22035183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist