MEDICARE: GIBSON APOTHECARY, LLC

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	3336L0003X	Long Term Care Pharmacy
2	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1891400990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIBSON APOTHECARY, LLC

Provider Business Mailing Address
First Line	:	813 HOSPITAL DR
Second Line	:
City	:	ANDREWS
State	:	TX
Zip	:	79714-3618
Country	:	US
Telephone Number	:	432-523-4861
Fax Number	:	432-524-4418

Provider Business Practice Location Address
First Line	:	5212 SINCLAIR AVE
Second Line	:
City	:	MIDLAND
State	:	TX
Zip	:	79707-6301
Country	:	US
Telephone Number	:	432-695-4950
Fax Number	:	432-355-5080

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. AARON PAUL GIBSON
Credential	:	PHARM.D., M.S.
Telephone Number	:	432-296-2170

Provider Enumeration Date	:	01/23/2023
Last Update Date	:	06/28/2023

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Directions to “GIBSON APOTHECARY, LLC ” Practice Location

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