Provider Demographics
NPI:1437498235
Name:TURGOOSE, GEORGE (PHARMD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:TURGOOSE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 12TH AVE RD
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-6313
Mailing Address - Country:US
Mailing Address - Phone:208-318-0536
Mailing Address - Fax:208-318-0542
Practice Address - Street 1:2219 12TH AVENUE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686
Practice Address - Country:US
Practice Address - Phone:208-318-0536
Practice Address - Fax:208-318-0542
Is Sole Proprietor?:No
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP6511183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist