MEDICARE: GIPS CO INVESTMENT CORP

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
1	3336C0004X	Compounding Pharmacy	02-0620450	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780763276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIPS CO INVESTMENT CORP

Provider Business Mailing Address
First Line	:	3216 SILSBY RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-3428
Country	:	US
Telephone Number	:	216-321-4300
Fax Number	:	213-321-4303

Provider Business Practice Location Address
First Line	:	3216 SILSBY RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-3428
Country	:	US
Telephone Number	:	216-321-4300
Fax Number	:	213-321-4303

Authorized Official
Title or Position	:	PHARMACY MANAGER
Name	:	ROBERT WRIGHT
Credential	:	RPH
Telephone Number	:	216-321-4300

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	07/15/2008

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Directions to “GIPS CO INVESTMENT CORP ” Practice Location

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