Gibbons Pharmacies LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHARCF00055919 Issued in WA

Legal business name

GIBBONS PHARMACIES LLC

Practice address

820 Memorial St
Suite 2
Prosser, WA 99350-2504

Phone

(509) 786-3200

Fax

(509) 786-7074

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Greg Gibbons

Title

Owner

Phone

(509) 865-2722

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• ELFERS LYON PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

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

• Gibbons Pharmacies LLC

  • Community/Retail Pharmacy
  • Toppenish, WA
  • NPI 1548275191

  O20040323000985

  Same enrollment
• Gibbons Pharmacies LLC

  • Community/Retail Pharmacy
  • Yakima, WA
  • NPI 1639184286

  O20040323000985

  Same enrollment

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeanine Noelette Charvet-Pederson, PHARMACIST

  • Pharmacist
  • Toppenish, WA
  • NPI 1750599817
  NPD (past)
• Gregory N. Gibbons, R.PH.

  • Pharmacist
  • Toppenish, WA
  • NPI 1619566783
  NPD (past)
• Daniel Joe Scott, RPH

  • Pharmacist
  • Prosser, WA
  • NPI 1245392083
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489017600000",
    "number": "1720093370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 MEMORIAL ST",
            "address_2": "SUITE 2",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993502504",
            "telephone_number": "509-786-3200",
            "fax_number": "509-786-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 MEMORIAL ST",
            "address_2": "SUITE 2",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993502504",
            "telephone_number": "509-786-3200",
            "fax_number": "509-786-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBBONS PHARMACIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2017-03-09",
        "status": "A",
        "authorized_official_last_name": "GIBBONS",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-865-2722"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "PHARCF00055919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2106990",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6021679",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELFERS LYON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zachary Ryan Garland, MSN, ARNP, FNP-C
• Dixie L George, MSW
• Laura H George, DPT
• Brian Gese
• Joel Gibb, D.C.
• Elena Fausto Gonzalez
• Scott Robert Gordon, MT (AMT)
• Spencer Edward Greer, D.D.S.
• Nancy Groff, P.T.
• Ashley Nicole Gunderson, RDN

• All providers in Prosser, WA
• Community/Retail Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; 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.