Organization
GEORGE'S FAMILY PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE GILLMAN RPH (PHARMACIST)
(765) 647-6251
Entity
Organization
Contact information
Practice address
480 MAIN ST, BROOKVILLE, IN 47012-1406
(765) 647-6251
(765) 647-6386
Mailing address
480 MAIN ST, BROOKVILLE, IN 47012-1406
(765) 647-6251
(765) 647-6386
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
60003113A
IN
333600000X
Pharmacy
Primary
60003113A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000097297
ANTHEM PROV ID NUMBER
—
05
—
100295890A
—
IN
01
—
1509794
NABP NUMBER
—
05
—
2167971
—
OH
01
—
P00110488
RAILROAD
IN
Enumeration date
05/24/2005
Last updated
03/13/2008
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