Organization
GIBSON FAMILY PHARMACY PC
Active
Organization
GIBSON FAMILY PHARMACY PC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
JIM HERMAN RPH (OWNER PHARMACIST)
(575) 762-4579
Entity
Organization
Contact information
Practice address
1801 W 21ST ST, CLOVIS, NM 88101-4023
(575) 762-4579
(575) 762-9612
Mailing address
1801 W 21ST ST, CLOVIS, NM 88101-4023
(575) 762-4579
(575) 762-9612
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PH1134
NM
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3200362
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
67454
—
NM
Enumeration date
11/15/2006
Last updated
03/07/2023
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