Organization
GEORGES FAMILY PHARMACY INC
Active
Other names
George's Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE GILLMAN (OWNER/CEO)
(812) 654-6251
Entity
Organization
Contact information
Practice address
124 W INDIAN TRL STE C, MILAN, IN 47031-8993
(812) 654-6251
(812) 654-4252
Mailing address
480 MAIN ST, BROOKVILLE, IN 47012-1406
(765) 647-6251
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60006384A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146916
PK
—
Enumeration date
07/21/2014
Last updated
01/26/2015
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