Organization
GIBSON SALES LP
Active
Other names
Drug Emporium 284
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD MAGLIOLO RPH (DIRECTOR OF PHARMACY)
(903) 297-0766
Entity
Organization
Contact information
Practice address
5614 S BROADWAY AVE, TYLER, TX 75703-4356
(903) 534-9105
(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
22542
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144275
—
TX
Enumeration date
05/16/2006
Last updated
03/27/2026
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