NPIMap

Organization Active NPI

Gibson Sales LP

Doing business as Drug Emporium 210

  • Community/Retail Pharmacy
  • Shreveport, LA
National Provider Identifier
1528019148
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1963RC Issued in LA
Legal business name
GIBSON SALES LP
Doing business as
Drug Emporium 210
Practice address
5819 E Kings Hwy
Shreveport, LA 71105-4303
Phone
(318) 861-7898
Fax
(903) 297-2895
NPI assigned
May 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Authorized official

Name
Richard Magliolo, RPH
Title
Director of Pharmacy
Phone
(903) 297-0766

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 1963RC LA Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

5819 E Kings Hwy
Shreveport, LA 71105-4303

Mailing address

PO Box 6238
Longview, TX 75608-6238
Phone (903) 297-0766

Other identifiers 1

IdentifierTypeStateIssuer
1264440MedicaidLA

Other names 1

  • Drug Emporium 210 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181207000203 LA Part B Supplier - Mass Immunization (Roster Biller Only) 5890919245 1 other NPI on this enrollment
Practice locations: Lafayette, LA; Shreveport, LA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Drug Emporium 2009 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

5819 E Kings Hwy
Shreveport, LA 71105
Phone (318) 861-7896

2321 W Loop 281
#A
Longview, TX 75604

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774569600000",
    "number": "1528019148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6238",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756086238",
            "telephone_number": "903-297-0766",
            "fax_number": "903-297-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5819 E KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054303",
            "telephone_number": "318-861-7898",
            "fax_number": "903-297-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBSON SALES LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A",
        "authorized_official_last_name": "MAGLIOLO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "903-297-0766",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "1963RC",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1264440",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drug Emporium 210",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.