Organization
GAS CITY DISTRIBUTORS INC
Active
Other names
GOOD NEIGHBOR PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY CHENEY RPH (PRESIDENT,AO)
(765) 674-6976
Entity
Organization
Contact information
Practice address
1030 E MAIN ST, GAS CITY, IN 46933-1621
(765) 674-6976
(765) 674-0114
Mailing address
PO BOX 128, GAS CITY, IN 46933-0128
(765) 674-6976
(765) 674-0114
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60004362A
IN
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100296200A
—
IN
01
—
2027532
PK
—
Enumeration date
03/28/2007
Last updated
05/02/2016
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