Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MANDERRIOUS L GLENN
Active Sole ProprietorMANDERRIOUS L GLENN is a Pharmacotherapy Specialist healthcare provider located in AUSTELL, Georgia. NPI 1154284388 is currently active in the NPPES registry. Verify at CMS.
Pharmacotherapy Specialist · AUSTELL, GA
Registration Details
- NPI Number
- 1154284388
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 4, 2025 (0.71949088525653 yrs)
- Last Updated
- Dec 4, 2025
- License
-
RPH035275 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3950 AUSTELL RDAUSTELL, GA, 301061121Browse GA providers · Browse ZIP 30106
- Phone
- 7707324000
- Primary Specialty
-
Pharmacotherapy Specialist
1835P1200X
Other Pharmacotherapy Specialist Providers in AUSTELL, GA
| Name | Credential | NPI |
|---|---|---|
| JARVETT COX | PHARMD | 1356141691 |
| SEANA-PIERRE WILLIAMS | — | 1447113683 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.