Provider Demographics
NPI:1093082562
Name:GEORGE, HYLEME S JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:HYLEME
Middle Name:S
Last Name:GEORGE
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 1/2 W LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64050-3709
Mailing Address - Country:US
Mailing Address - Phone:816-833-4400
Mailing Address - Fax:816-461-5361
Practice Address - Street 1:209 1/2 W LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64050-3709
Practice Address - Country:US
Practice Address - Phone:816-833-4400
Practice Address - Fax:816-461-5361
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005020330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist