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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