Organization
GIBSONS PHARMACY INC
Active
Other names
GIBSONS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY WARDELL RPH (OWNER)
(801) 262-5526
Entity
Organization
Contact information
Practice address
240 E 6400 S, MURRAY, UT 84107-7305
(801) 262-5526
(801) 262-0125
Mailing address
240 E 6400 S, MURRAY, UT 84107-7305
(801) 262-5526
(801) 262-0125
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1295101703
UT
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2107702
PK
—
Enumeration date
08/31/2006
Last updated
10/04/2013
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