# GIBSONBURG PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PILLS N PACKAGES
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639241144
- **Authorized official:** MICHAEL WARREN (OWNER AND PRES)
- **Authorized official phone:** (419) 637-7441

## Contact information

- **Practice address:** 350 RICE ST, ELMORE, OH 43416
- **Practice address phone:** (419) 862-2982
- **Practice address fax:** (419) 862-9006
- **Mailing address:** PO BOX 11, ELMORE, OH 43416-0011
- **Mailing address phone:** (419) 862-2982

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 020455650 | OH | Yes |

## Other

- **Enumeration date:** 11/14/2006
- **Last updated:** 03/08/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0618559 | — | OH |
| 01 | — | 2076680 | PK | — |