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Organization

GIBSON DISCOUNT PHARMACY OF MARSHALL INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JIM EASLEY RPH (OWNER/PHARMACIST)
(903) 935-7775
Entity
Organization

Contact information

Practice address
110 E END BLVD N, MARSHALL, TX 75670-3602
(903) 935-7775
(903) 938-3521
Mailing address
110 E END BLVD N, MARSHALL, TX 75670-3602
(903) 935-7775
(903) 938-3521

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
00352
TX
333600000X
Pharmacy
Primary
00352
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010944901
TX
05
108393301
TX
05
120675
TX
01
4510942
NABP
TX
Enumeration date
09/27/2005
Last updated
03/12/2010
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