Provider Demographics
NPI:1689676447
Name:PAPPAS, GEORGE L (RPH)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:L
Last Name:PAPPAS
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 1:76 MACARTHUR DR
Mailing Address - Street 2:
Mailing Address - City:MILLBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01527-3547
Mailing Address - Country:US
Mailing Address - Phone:413-504-4492
Mailing Address - Fax:
Practice Address - Street 1:2145 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-1650
Practice Address - Country:US
Practice Address - Phone:413-504-4492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9456183500000X, 1835N1003X, 1835P1200X, 1835P1300X
MA17660183500000X, 1835N1003X, 1835P1200X, 1835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P1300XPharmacy Service ProvidersPharmacistPsychiatric