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Organization
GIBSON COMMUNITY HOSPITAL ASSOCIATION
Active
Organization
GIBSON COMMUNITY HOSPITAL ASSOCIATION
Active
Parent organization
GIBSON COMMUNITY HOSPITAL ASSOCIATION
Other names
Gibson Family Pharmacy, A Member of the Medicine Shoppe Family
Organization subpart
Yes
Provider details
NPI number
Legal business name
GIBSON COMMUNITY HOSPITAL ASSOCIATION
Authorized official
MR. MATTHEW ERTEL (CHIEF FINANCIAL OFFICER)
(217) 784-4251
Entity
Organization
Contact information
Practice address
104 N. SANGAMON AVE, GIBSON CITY, IL 60936-1343
(217) 784-8545
(217) 784-8039
Mailing address
1120 N. MELVIN ST, GIBSON CITY, IL 60936-1477
(217) 784-8545
(217) 784-8039
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054015227
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1422853
NCPDP #
IL
05
—
550868762001
—
IL
Enumeration date
07/17/2006
Last updated
07/17/2023
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