Provider Demographics
NPI:1508139247
Name:KALAMS, GEORGE DAVID (RPH)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:DAVID
Last Name:KALAMS
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 1:509 N BARNEBURG RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6678
Mailing Address - Country:US
Mailing Address - Phone:541-772-3461
Mailing Address - Fax:
Practice Address - Street 1:509 N BARNEBURG RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6678
Practice Address - Country:US
Practice Address - Phone:541-772-3461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6259183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR6259OtherSTATE PHARMACIST LICENSE