| NPI | 1861533820 |
|---|---|
| Other Name | GIBSON PHARMACY |
| Entity Type | Organization |
| Authorized Contact | FRED S FORTENBERRY Pres 662-226-6589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 00662) |
| Enumeration Date | 2007-02-10 |
| Last Update Date | 2020-08-22 |