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General NPI Number Information
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NPI Number | 1407374234
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Entity Type | Individual
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Provider Name | ERIC ASHLEY GIBSON RPH
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Gender | Male
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Dates
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Enumeration Date | 08/31/2017
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Last Update Date | 08/31/2017
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Provider Practice Location Address
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Address Line | 10405 LIONS HEART
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City | LITTLETON
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State | CO
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Zip | 80124-9529
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Country | US
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Telephone | 615-613-4828
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Fax | 615-613-4828
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Provider Business Mailing Address
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Address Line | 10405 LIONS HEART
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City | LITTLETON
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State | CO
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Zip | 80124-9529
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Country | US
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Telephone | 615-613-4828
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PS28581
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License Number State | FL
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