Provider Demographics
NPI:1417983966
Name:GILSTRAP DRUGS INC
Entity Type:Organization
Organization Name:GILSTRAP DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:DYESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-684-2272
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:AL
Mailing Address - Zip Code:36340
Mailing Address - Country:US
Mailing Address - Phone:334-684-2272
Mailing Address - Fax:334-684-2273
Practice Address - Street 1:501 SOUTH COMMERCE STREET
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:AL
Practice Address - Zip Code:36340
Practice Address - Country:US
Practice Address - Phone:334-684-2272
Practice Address - Fax:334-684-2273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14153183500000X
AL111831333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL3954250001Medicare ID - Type Unspecified