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
24128 STATE LINE RD, LAWRENCEBURG, IN 47025-7387
(765) 647-6251
Mailing address
24128 STATE LINE RD, LAWRENCEBURG, IN 47025-7387
(765) 647-6251
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60006329A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1564524
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/21/2013
Last updated
03/21/2013
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