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Organization
GIBSON SALES LP
Active
Organization
GIBSON SALES LP
Active
Other names
Drug Emporium 210
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD MAGLIOLO RPH (DIRECTOR OF PHARMACY)
(903) 297-0766
Entity
Organization
Contact information
Practice address
5819 E KINGS HWY, SHREVEPORT, LA 71105-4303
(318) 861-7898
(903) 297-2895
Mailing address
PO BOX 6238, LONGVIEW, TX 75608-6238
(903) 297-0766
(903) 297-2895
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
1963RC
LA
3336C0004X
Compounding Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1264440
—
LA
Enumeration date
05/16/2006
Last updated
03/27/2026
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