Provider Demographics
NPI:1174694848
Name:GWINNS DRUG STORES INC
Entity type:Organization
Organization Name:GWINNS DRUG STORES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:765-643-3716
Mailing Address - Street 1:505 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46016
Mailing Address - Country:US
Mailing Address - Phone:765-643-3716
Mailing Address - Fax:765-643-0265
Practice Address - Street 1:505 MADISON AVE
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016
Practice Address - Country:US
Practice Address - Phone:765-643-3716
Practice Address - Fax:765-643-0265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN60000869A3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy