NPIMap

Organization Active NPI

George's Family Pharmacy, Inc.

  • Pharmacy
  • Connersville, IN
National Provider Identifier
1033614557
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
60006665A Issued in IN
Legal business name
GEORGE'S FAMILY PHARMACY, INC.
Doing business as
George's Family Pharmacy, Inc.
Practice address
330 E 5TH St
Connersville, IN 47331-2604
Phone
(765) 825-6386
Fax
(765) 825-6386
NPI assigned
Mar 27, 2018
Last updated
Mar 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Blake Gillman
Title
Owner
Phone
(765) 647-6251

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 60006665A IN Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

330 E 5TH St
Connersville, IN 47331-2604

Mailing address

480 Main St
Brookville, IN 47012-1406
Phone (765) 647-6251

Other identifiers 1

IdentifierTypeStateIssuer
2176679OtherPK

Other names 1

  • George's Family Pharmacy, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080321000158 IN Part B Supplier - Mass Immunization (Roster Biller Only) 4981784667 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Batesville, IN; Brookville, IN
O20191202002441 IN DME Supplier - PharmacyDME Supplier - Oxygen & EquipmentDME Supplier - Medical Supply Company With Registered PharmacistDME Supplier - Medical Supply Company With Respiratory Therapist 4981784667 Practice locations: Connersville, IN

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Georges Family Pharmacy Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

330 E 5th St
Connersville, IN 47331
Phone (765) 825-6251

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1033614557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 MAIN ST",
            "city": "BROOKVILLE",
            "state": "IN",
            "postal_code": "470121406",
            "telephone_number": "765-647-6251",
            "fax_number": "765-647-6386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E 5TH ST",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312604",
            "telephone_number": "765-825-6386",
            "fax_number": "765-825-6386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE'S FAMILY PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "GILLMAN",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-647-6251"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IN",
            "license": "60006665A",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176679",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "George's Family Pharmacy, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Connersville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.