Provider Demographics
NPI:1457645582
Name:GILBERT, MIKEL (RPH)
Entity Type:Individual
Prefix:
First Name:MIKEL
Middle Name:
Last Name:GILBERT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 SCHILLINGER RD S
Mailing Address - Street 2:TARGET PHARMACY
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-8979
Mailing Address - Country:US
Mailing Address - Phone:251-776-1512
Mailing Address - Fax:251-776-1512
Practice Address - Street 1:790 SCHILLINGER RD S
Practice Address - Street 2:TARGET PHARMACY
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-8979
Practice Address - Country:US
Practice Address - Phone:251-776-1512
Practice Address - Fax:251-776-1512
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10158183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist