# GLUCKSTADT PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gluckstadt Pharmacy LTC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003507393
- **Authorized official:** DAVID R BERRY (OWNER/MEMBER)
- **Authorized official phone:** (601) 859-3939

## Contact information

- **Practice address:** 154 CALHOUN STATION PARKWAY, SUITE 1, GLUCKSTADT, MS 39110
- **Practice address phone:** (601) 720-2290
- **Practice address fax:** (601) 790-2292
- **Mailing address:** 195 E PEACE ST, CANTON, MS 39046-4519
- **Mailing address phone:** (601) 859-3939
- **Mailing address fax:** (601) 855-2133

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/17/2023
- **Last updated:** 10/19/2023