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Contact Information

GIBSONBURG PHARMACY INC
350 RICE ST
ELMORE, OH43416
 Phone: 419-862-2982
 Fax: 419-862-9006
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for GIBSONBURG PHARMACY INC

NPI # 1639241144
LBN Legal business name GIBSONBURG PHARMACY INC
Authorized official MICHAEL WARREN - (OWNER AND PRES)
Entity Organization
Organization subpart 1 No
Enumeration date 11/14/2006
Last updated 03/08/2017 - About 9 years ago
Identifiers
OH License # 020455650
OH Medicaid 0618559
Other 2076680 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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