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General NPI Number Information
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NPI Number | 1902947849
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Entity Type | Organization
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Legal Business Name | GILMER DRUG COMPANY
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 112 DAVIS ST
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City | GILMER
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State | TX
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Zip | 75644-2210
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Country | US
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Telephone | 903-843-5631
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Fax | 903-843-5603
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Provider Business Mailing Address
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Address Line | 112 DAVIS ST
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City | GILMER
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State | TX
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Zip | 75644-2210
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Country | US
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Telephone | 903-843-5631
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Fax | 903-843-5603
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Authorized Official
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Title or Position | PHARMACIST
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Name | BOB BATES
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Credential |
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Telephone | 903-843-5631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 06819
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License Number State | TX
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