Provider Demographics
NPI:1659650687
Name:ANTHONY, GEORGE (RPH)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:ANTHONY
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 1:101 MAIN ST E
Mailing Address - Street 2:
Mailing Address - City:LOCUST
Mailing Address - State:NC
Mailing Address - Zip Code:28097-9723
Mailing Address - Country:US
Mailing Address - Phone:704-888-6650
Mailing Address - Fax:
Practice Address - Street 1:101 MAIN ST E
Practice Address - Street 2:
Practice Address - City:LOCUST
Practice Address - State:NC
Practice Address - Zip Code:28097-9723
Practice Address - Country:US
Practice Address - Phone:704-888-6650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10860183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist