Provider Demographics
NPI:1093178535
Name:ELIAS, GEORGE (RPH)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:ELIAS
Suffix:
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 1:125 ROBERT TONER BLVD
Mailing Address - Street 2:OSCO PHARMACY DEPT/ SHAW'S SUPERMARKET
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760
Mailing Address - Country:US
Mailing Address - Phone:508-643-0312
Mailing Address - Fax:508-643-3478
Practice Address - Street 1:125 ROBERT TONER BLVD
Practice Address - Street 2:OSCO PHARMACY DEPT/ SHAW'S SUPERMARKET
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760
Practice Address - Country:US
Practice Address - Phone:508-643-0312
Practice Address - Fax:508-643-3478
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist