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General NPI Number Information
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NPI Number | 1407714306
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Entity Type | Organization
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Legal Business Name | GG II INDIANA, LLC
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 2810 NICHOL AVE
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City | ANDERSON
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State | IN
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Zip | 46011-3142
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Country | US
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Telephone | 765-789-0157
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Fax | 765-789-0422
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Provider Business Mailing Address
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Address Line | 1550 GEZON PKWY SW
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City | WYOMING
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State | MI
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Zip | 49509-9397
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Country | US
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Telephone | 616-878-2848
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Fax | 616-878-2848
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Authorized Official
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Title or Position | DIRECTOR, PHARMACY MERCHANDISING
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Name | AMY R ELLIS
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Credential | RPH
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Telephone | 616-878-2848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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