Provider Demographics
NPI:1568665693
Name:GEORGE, MICHELE RENEE (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:RENEE
Last Name:GEORGE
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 STATE ROUTE 356
Mailing Address - Street 2:
Mailing Address - City:LEECHBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15656-2026
Mailing Address - Country:US
Mailing Address - Phone:724-845-2801
Mailing Address - Fax:
Practice Address - Street 1:1529 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-1314
Practice Address - Country:US
Practice Address - Phone:724-226-4725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439878183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP439878OtherPHARMACIST LICENSE NUMBER