Provider Demographics
NPI:1790840403
Name:GEORGE, WILLIAM LAWRENCE (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:LAWRENCE
Last Name:GEORGE
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 1:190 LORINDA LN
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-8200
Mailing Address - Country:US
Mailing Address - Phone:814-383-4827
Mailing Address - Fax:
Practice Address - Street 1:724 S ATHERTON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-4628
Practice Address - Country:US
Practice Address - Phone:814-238-2712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034133L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist