Provider Demographics
NPI:1497899769
Name:KOREY, GERALD P (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:P
Last Name:KOREY
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 BENBROOKE CT NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-8489
Mailing Address - Country:US
Mailing Address - Phone:678-355-9004
Mailing Address - Fax:678-355-9825
Practice Address - Street 1:1042 RED BUD RD NE
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-2081
Practice Address - Country:US
Practice Address - Phone:706-629-9139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH021924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist