Provider Demographics
NPI:1407063274
Name:KENSON, GEORGE H (RPH)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:H
Last Name:KENSON
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 1:30 COTA RD
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-4069
Mailing Address - Country:US
Mailing Address - Phone:603-424-3961
Mailing Address - Fax:
Practice Address - Street 1:30 COTA RD
Practice Address - Street 2:
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054-4069
Practice Address - Country:US
Practice Address - Phone:603-424-3961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR602183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist