NPIMap

Organization Active NPI

Gibson Sales LP

  • Community/Retail Pharmacy
  • Tyler, TX
National Provider Identifier
1700837382
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
22542 Issued in TX
Legal business name
GIBSON SALES LP
Practice address
5614 S Broadway Ave
Tyler, TX 75703-4356
Phone
(903) 534-9105
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 22542 TX Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

5614 S Broadway Ave
Tyler, TX 75703-4356

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
144275MedicaidTX

Other names 1

  • Drug Emporium 284 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140605000795 TX Part B Supplier - Mass Immunization (Roster Biller Only) 5890919245 6 other NPIs on this enrollment
Practice locations: Waco, TX; Tyler, TX; Lubbock, TX; Amarillo, TX; Abilene, TX; Longview, TX

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 6

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

5614 S Broadway Ave
Tyler, TX 75703
Phone (903) 534-9105

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": "1700837382",
    "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": "5614 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034356",
            "telephone_number": "903-534-9105",
            "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": "TX",
            "license": "22542",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144275",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drug Emporium 284",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tyler, TX

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.