GIBRALTAR PHARMACY INC (NPI# 1609984079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609984079 |
| Entity Type | Organization |
| Organization Name | GIBRALTAR PHARMACY INC |
| Other Organization Name | GIBRALTAR SAV-MOR PHARMACY #16 |
| Practice Address |
29255 W Jefferson Ave Gibraltar MI 48173-9738 |
| Mailing Address |
25625 Southfield Rd Ste 206 Southfield MI 48075-1854 |
| Practice Telephone | 7346750000 |
| Practice Fax Number | 7346750066 |
| Mailing Telephone | 2483481570 |
| Mailing Fax Number | 2483484316 |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2018-07-19 |
| Authorized Official Name | DOUGLAS BOOKER (PHARMACIST/MGR) |
| Authorized Official Telephone | 7346750000 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301007472 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2363137 | 05 | |
| PK | 2045990 | 01 |
| Other Name | Type Code |
|---|---|
| GIBRALTAR SAV-MOR PHARMACY #16 | Doing Business As Name - Organization |
| Street Address |
29255 W JEFFERSON AVE |
| City | GIBRALTAR |
| State | MI |
| Zip Code | 48173-9738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316022502 | Donovan Matthew Haddix | Pharmacist | 29255 W Jefferson Ave, Gibraltar, MI 48173-9738 | 2006-10-26 |
| 1336239847 | Lori Jean Vanevery | Pharmacist | 29255 W Jefferson Ave, Gibraltar, MI 48173-9738 | 2006-10-13 |
| 1386732519 | Douglas Booker | Pharmacist | 29255 W Jefferson Ave, Gibraltar, MI 48173-9738 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508416355 | Stephanie Lauren Marl | Nurse Practitioner | 29800 Adams Dr, Gibraltar, MI 48173 | 2019-09-13 |
| 1568770493 | Janis Lee Gilliam | Massage Therapist | 32121 Old Fort, Rockwood, MI 48173 | 2010-09-14 |
| 1982807913 | Lisa G Heidemann | Registered Nurse | 1450 S Lapeer, Oxford, MI 48173 | 2007-06-07 |
| 1215066279 | Craig Arlen Birch | Dentist | 21969 Huron River Drive, Rockwood, MI 48173 | 2007-03-05 |
| 1992850226 | Chad Jason Eschliman | Radiologic Technologist | 33285 Spoonbill Ave, Brownstown, MI 48173 | 2007-01-25 |
| 1871983072 | Karen Cupp | Psychologist | 21825 Woodruff Rd, Apt G3, Rockwood, MI 48173-1062 | 2015-01-27 |
| 1093016438 | Susans Total Care Drug Store LLC | Durable Medical Equipment & Medical Supplies | 22432 Huron River Dr, Rockwood, MI 48173-1100 | 2010-11-16 |
| 1407895865 | City of Rockwood | Ambulance | 32409 Fort Rd, Rockwood, MI 48173-1111 | 2006-06-04 |
| 1083934988 | Robin Elizabeth Burnstein | Pharmacist | 32905 Fort Rd, Rockwood, MI 48173-1112 | 2010-06-03 |
| 1659394211 | Perry Drug Stores Inc and Subsidiaries | Durable Medical Equipment & Medical Supplies | 32905 Fort Street, Rockwood, MI 48173-1112 | 2006-07-25 |
| Find all providers in zip 48173 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| 1821606310 | S&k Pharmacy Inc. | Pharmacy | 1916 Davison Rd, Flint, MI 48506-4423 | 2020-07-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.