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General NPI Number Information
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NPI Number | 1427010388
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Entity Type | Organization
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Legal Business Name | GILBERTS DRUG STORE INC
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 212 S STATE ST
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City | OSCODA
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State | MI
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Zip | 48750-1635
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Country | US
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Telephone | 989-739-7585
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Fax | 989-739-5739
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Provider Business Mailing Address
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Address Line | PO BOX 130
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City | OSCODA
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State | MI
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Zip | 48750-0130
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Country | US
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Telephone | 989-739-7585
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN GILBERT
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Credential |
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Telephone | 989-739-7585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301001312
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License Number State | MI
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