NPI 1013483601

Juanice Gandy Glaze

Practitioner Pharmacist Hattiesburg, MS

Practice location

Address: 6051 U S Highway 49, Hattiesburg, MS 39401-7200
Phone: (601) 288-4276
Fax: (601) 288-4163
Mailing address: 3800 Jamestown Rd, Hattiesburg, MS 39402-2335

Registered specialties (2)

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence E06754 (MS)

Other Pharmacist providers in Mississippi →

Pharmacist

Pharmacy Service Providers Taxonomy 183500000X Licence E-06754 (MS)

Registry record

NPI: 1013483601
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Oct 2018
Record last updated: 22 Oct 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.