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General NPI Number Information
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NPI Number | 1053314021
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Entity Type | Organization
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Legal Business Name | GEORGE'S FAMILY PHARMACY INC
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 03/13/2008
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Provider Practice Location Address
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Address Line | 480 MAIN ST
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City | BROOKVILLE
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State | IN
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Zip | 47012-1406
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Country | US
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Telephone | 765-647-6251
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Fax | 765-647-6386
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Provider Business Mailing Address
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Address Line | 480 MAIN ST
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City | BROOKVILLE
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State | IN
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Zip | 47012-1406
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Country | US
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Telephone | 765-647-6251
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Fax | 765-647-6386
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. GEORGE GILLMAN
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Credential | RPH
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Telephone | 765-647-6251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 60003113A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 60003113A
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License Number State | IN
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