Organization
GEORGE'S FAMILY PHARMACY, INC.
Active
Other names
George's Family Pharmacy, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE GILLMAN (OWNER/CEO)
(765) 265-4699
Entity
Organization
Contact information
Practice address
326 S. WASHINGTON ST. SUITE 22, VERSAILLES, IN 47042
(812) 689-0200
(812) 689-0201
Mailing address
326 S. WASHINGTON ST. SUITE 22, VERSAILLES, IN 47042
(812) 689-0200
(812) 689-0201
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60006249A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1563306
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
300079697
—
IN
Enumeration date
04/13/2011
Last updated
08/21/2023
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