Provider Demographics
NPI:1275945677
Name:POLHEMUS, GEORGE ARVIN I (RPH)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:ARVIN
Last Name:POLHEMUS
Suffix:I
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 1:764 MARINER LOOP
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-7532
Mailing Address - Country:US
Mailing Address - Phone:530-763-4359
Mailing Address - Fax:
Practice Address - Street 1:2325 MYERS ST
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-5476
Practice Address - Country:US
Practice Address - Phone:530-533-6876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist