NPIMap

Organization Active NPI

George's Family Pharmacy, Inc.

Doing business as George's Pharmacy East Side, LLC

  • Pharmacy
  • Indianapolis, IN
National Provider Identifier
1801854047
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
GEORGE'S FAMILY PHARMACY, INC.
Doing business as
George's Pharmacy East Side, LLC
Practice address
5543 E Washington St
Indianapolis, IN 46219-6448
Phone
(317) 359-8278
Fax
(317) 359-3400
NPI assigned
May 3, 2006
Last updated
Mar 1, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
GEORGE'S PHARMACY EAST SIDE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Authorized official

Name
Blake Cly Gillman
Title
Owner/Ceo
Phone
(765) 265-4699

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary
Community/Retail Pharmacy 3336C0003X 60000438A IN

Addresses

Primary practice location

5543 E Washington St
Indianapolis, IN 46219-6448

Mailing address

5543 E Washington St
Indianapolis, IN 46219-6448
Phone (317) 359-8278

Other identifiers 1

IdentifierTypeStateIssuer
100291870AMedicaidIN

Other names 1

  • George's Pharmacy East Side, LLC 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
O20210716000641 IN DME Supplier - Medical Supply Company With Registered PharmacistDME Supplier - Medical Supply Company With Respiratory Therapist 4981784667 Practice locations: Indianapolis, 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.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
George's Pharmacy East Side, LLC5543 E Washington St, Indianapolis, IN 46219-6448(317) 359-8278 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf|Nebulizer Equipment and/or Supplies|Surgical Dressings Does not accept assignmentParticipating since Jan 1, 2008

National Provider Directory

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

Other organizations with this tax ID 12

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

Locations

1198 State Road 46 E
Batesville, IN 47006
Phone (812) 932-6251

1198 State Route 46 E
Batesville, IN 47006
Phone (812) 932-6251

5543 E Washington St
Indianapolis, IN 46219
Phone (317) 359-8278

326 S Washington St
Ste 1
Versailles, IN 47042
Phone (812) 689-0200

326 S Washington St
Ste 22
Versailles, IN 47042
Phone (812) 689-0200

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1801854047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5543 E WASHINGTON ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462196448",
            "telephone_number": "317-359-8278",
            "fax_number": "317-359-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5543 E WASHINGTON ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462196448",
            "telephone_number": "317-359-8278",
            "fax_number": "317-359-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE'S FAMILY PHARMACY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGE'S PHARMACY EAST SIDE, LLC",
        "enumeration_date": "2006-05-03",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "GILLMAN",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "CLY",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "765-265-4699"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60000438A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100291870A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "George's Pharmacy East Side, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.