MEDICARE: DR. CHRISTOPHER CHARLES GIBSON PHARMD

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	183500000X	Pharmacist	03236967	OH

General Provider Information

NPI Number	:	1811511629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER CHARLES GIBSON PHARMD

Provider Business Mailing Address
First Line	:	6204 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45213-1404
Country	:	US
Telephone Number	:	513-731-2272
Fax Number	:	513-731-0651

Provider Business Practice Location Address
First Line	:	6204 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45213-1404
Country	:	US
Telephone Number	:	513-731-2272
Fax Number	:	513-731-0651

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2020
Last Update Date	:	06/08/2020

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