Healthcare Provider Details

I. General information

NPI: 1477484012
Provider Name (Legal Business Name): GEORGE'S FAMILY PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 S WASHINGTON ST
VERSAILLES IN
47042-8042
US

IV. Provider business mailing address

480 MAIN ST
BROOKVILLE IN
47012-1406
US

V. Phone/Fax

Practice location:
  • Phone: 812-689-6251
  • Fax:
Mailing address:
  • Phone: 765-647-6251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BLAKE GILLMAN
Title or Position: OWNER/CEO
Credential:
Phone: 765-647-6251