Basic Information
| Provider Information | |||||||||
| NPI: | 1528349727 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GIBSON | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | LENORE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARM. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2350 PLANET AVE | ||||||||
| Address2: | |||||||||
| City: | SALINA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 674017514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858239515 | ||||||||
| FaxNumber: | 7854523530 | ||||||||
| Practice Location | |||||||||
| Address1: | 2350 PLANET AVE | ||||||||
| Address2: | |||||||||
| City: | SALINA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 674017514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858239515 | ||||||||
| FaxNumber: | 7854523530 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2011 | ||||||||
| LastUpdateDate: | 07/15/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 1-14552 | KS | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.