Organization
RANDY'S GATEWAY DRUG, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES H GIBSON RPH (PHARMACIST/PRESIDENT)
(276) 964-2494
Entity
Organization
Contact information
Practice address
3118 CEDAR VALLEY DR, RICHLANDS, VA 24641-3075
(276) 964-2494
(276) 963-2920
Mailing address
3118 CEDAR VALLEY DR, RICHLANDS, VA 24641-3075
(276) 964-2494
(276) 963-2920
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0201003219
VA
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8505756
—
VA
Enumeration date
07/28/2005
Last updated
08/31/2024
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