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
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1963RC
LA
3336C0004X
Compounding Pharmacy
—
—
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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