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Deactivated NPI 1538450358 Deactivated / Inactive NPI Male Practitioner

Glen Edward Nichols , RPH

Pharmacist • Fenton, MI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Glen Nichols has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 27, 2011
NPI Deactivation Date June 19, 2018
Total Practice Duration ~7 Years of Practice (2011 – 2018)

Professional Overview & Biography Verified Profile Summary

Glen Nichols, RPH was a registered Pharmacist practicing in Fenton, MI. Throughout an active medical career spanning 7 years, Glen Nichols provided care at the practice location at 1001 N LEROY ST until profile deactivation on 2018-06-19.

Practice Location & Contact Primary Location

Practice Address

1001 N Leroy St

Fenton, MI 484305308

Telephone 8107501923
Fax 8107144128
Associated Practice Facility / Clinic
🏢 Apex Drug Stores Inc Facility NPI 1730298290

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Fenton, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.0 Yrs
Regional Practice Density
27 Specialists

Practicing in Fenton, MI (8602 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License MI 5302022513

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Erica Dennis , CPHT

Pharmacy Technician

NPI 1053989566

Certified Pharmacy Technician

Ashley Kochan

Pharmacy Technician

NPI 1225564735
Alexis Weber

Pharmacy Technician

NPI 1538864137
NPI 1780975359

Registered Pharmacist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 19, 2018

Record deactivated on June 19, 2018

NPI Profile Active April 27, 2011

NPI status registered as active in NPPES database

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Updated Practice Location April 27, 2011

Registered at 1001 N LEROY ST, FENTON, MI 484305308 (Tel: 8107501923)

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Updated Business Mailing Address April 27, 2011

Registered at 1001 N LEROY ST, FENTON, MI 484305308 (Tel: 8107501923)

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Provider Name / Credentials Updated April 27, 2011

Recorded as GLEN NICHOLS, R.PH

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 27, 2011

Pharmacist (License #5302022513 in MI)

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Initial NPI Registration & Enumeration April 27, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1538450358
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 27, 2011
Last Update: April 27, 2011
Deactivation Date: June 19, 2018

Mailing Address

1001 N Leroy St

Fenton, MI 484305308

Phone: 8107501923

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.