Gibson Discount Pharmacy of Marshall Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

00352 Issued in TX

Legal business name

GIBSON DISCOUNT PHARMACY OF MARSHALL INC

Practice address

110 E End Blvd N
Marshall, TX 75670-3602

Phone

(903) 935-7775

Fax

(903) 938-3521

NPI assigned

Sep 27, 2005

Organization subpart

No

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

Authorized official

Name

Jim Easley, RPH

Title

Owner/Pharmacist

Phone

(903) 935-7775

Specialties & licenses 2

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268352000000",
    "number": "1851388508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E END BLVD N",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756703602",
            "telephone_number": "903-935-7775",
            "fax_number": "903-938-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E END BLVD N",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756703602",
            "telephone_number": "903-935-7775",
            "fax_number": "903-938-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBSON DISCOUNT PHARMACY OF MARSHALL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2010-03-12",
        "status": "A",
        "authorized_official_last_name": "EASLEY",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "903-935-7775",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "00352",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "00352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108393301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "4510942",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120675",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010944901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in Marshall, TX
• Providers in Marshall, TX by specialty
• Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; 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.