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General NPI Number Information
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NPI Number | 1053479758
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Entity Type | Organization
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Legal Business Name | GIBSON MCWHIRT CORP
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 700 S LIMIT AVE
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City | SEDALIA
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State | MO
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Zip | 65301-3900
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Country | US
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Telephone | 660-826-2431
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Fax | 660-826-2713
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Provider Business Mailing Address
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Address Line | 700 S LIMIT AVE
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City | SEDALIA
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State | MO
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Zip | 65301-3900
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Country | US
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Telephone | 660-826-2431
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Fax | 660-826-2713
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Authorized Official
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Title or Position | PHARMACIST
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Name | JOHN KNORP
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Credential | R.PH.
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Telephone | 660-826-2431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 028824
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License Number State | MO
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