Provider Demographics
NPI:1699980326
Name:GIBBS, DAVID PAUL (RPH, BCOP, CPP)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:PAUL
Last Name:GIBBS
Suffix:
Gender:M
Credentials:RPH, BCOP, CPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 SHEFFIELD DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-8779
Mailing Address - Country:US
Mailing Address - Phone:252-341-1894
Mailing Address - Fax:
Practice Address - Street 1:600 MOYE BLVD
Practice Address - Street 2:LJCC PHARMACY ROOM 240
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4300
Practice Address - Country:US
Practice Address - Phone:252-847-7670
Practice Address - Fax:252-847-9069
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC145011835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology