Provider Demographics
NPI:1891400990
Name:GIBSON APOTHECARY, LLC
Entity Type:Organization
Organization Name:GIBSON APOTHECARY, LLC
Other - Org Name:ALVA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, MS
Authorized Official - Phone:432-296-2170
Mailing Address - Street 1:813 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:TX
Mailing Address - Zip Code:79714-3618
Mailing Address - Country:US
Mailing Address - Phone:432-523-4861
Mailing Address - Fax:432-524-4418
Practice Address - Street 1:5212 SINCLAIR AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-6301
Practice Address - Country:US
Practice Address - Phone:432-695-4950
Practice Address - Fax:432-355-5080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy