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NPI Code Detail

MEDICARE: DR. CHARMAINE GIBSON PHARM. D.

MEDICARE: DR. CHARMAINE GIBSON PHARM. D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist44182TX

General Provider Information

NPI Number : 1558690438
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARMAINE GIBSON PHARM. D.
Provider Business Mailing Address
First Line : 1507 W PLEASANT RUN RD
Second Line :
City : LANCASTER
State : TX
Zip : 75146-1213
Country : US
Telephone Number : 972-218-6446
Fax Number : 972-218-6893
Provider Business Practice Location Address
First Line : 1507 W PLEASANT RUN RD
Second Line :
City : LANCASTER
State : TX
Zip : 75146-1213
Country : US
Telephone Number : 972-218-6446
Fax Number : 972-218-6893
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2009
Last Update Date : 12/23/2009

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