# GLIMPSE PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679443501
- **Authorized official:** SURROUROSSADAT LAVASSANI (OWNER)
- **Authorized official phone:** (404) 556-8373

## Contact information

- **Practice address:** 3970 PEACHTREE INDUSTRIAL BLVD STE 100, BERKELEY LAKE, GA 30096-4813
- **Practice address phone:** (404) 556-8373
- **Mailing address:** 3970 PEACHTREE INDUSTRIAL BLVD STE 100, BERKELEY LAKE, GA 30096-4813
- **Mailing address phone:** (404) 556-8373

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 11/06/2025
- **Last updated:** 11/06/2025