Organization
GEORGE'S FAMILY PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE GILLMAN (OWNER/CEO)
(765) 647-6251
Entity
Organization
Contact information
Practice address
330 E 5TH ST, CONNERSVILLE, IN 47331-2604
(765) 825-6251
Mailing address
330 E 5TH ST, CONNERSVILLE, IN 47331-2604
(765) 825-6251
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300027007
—
IN
Enumeration date
10/07/2024
Last updated
10/07/2024
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