NPIMap

Organization Active NPI

Gibson Family Pharmacy PC

Doing business as Family Institutional Pharmacy Services

  • Long Term Care Pharmacy
  • Clovis, NM
National Provider Identifier
1043341951
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PH001818 Issued in NM
Legal business name
GIBSON FAMILY PHARMACY PC
Doing business as
Family Institutional Pharmacy Services
Practice address
1801 W 21St St Ste B
Clovis, NM 88101-4023
Phone
(505) 762-9621
Fax
(505) 762-9612
NPI assigned
Mar 9, 2007
Last updated
Sep 12, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James Herman, RPH
Title
Pic and President
Phone
(505) 762-9621

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU
Institutional Pharmacy 3336I0012X NU
Long Term Care Pharmacy 3336L0003X PH001818 NM Primary

Addresses

Primary practice location

1801 W 21St St Ste B
Clovis, NM 88101-4023

Mailing address

1801 W 21St St Ste B
Clovis, NM 88101-4023

Other identifiers 3

IdentifierTypeStateIssuer
661617MedicaidNM
3209346OtherOTHER ID NUMBER
3209346OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • FAMILY INSTITUTIONAL PHARMACY SERVICES Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Institutional Pharmacy Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1801 W 21st St
Ste B
Clovis, NM 88101
Phone (505) 762-9621

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1043341951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W 21ST ST STE B",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W 21ST ST STE B",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014023",
            "telephone_number": "505-762-9621",
            "fax_number": "505-762-9612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBSON FAMILY PHARMACY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PIC AND PRESIDENT",
        "authorized_official_telephone_number": "505-762-9621",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NM",
            "license": "PH001818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "661617",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "3209346",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3209346",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY INSTITUTIONAL PHARMACY SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clovis, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.