Provider Demographics
NPI:1851993232
Name:MOUSER, GEORGE BENNIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:BENNIE
Last Name:MOUSER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-3509
Mailing Address - Country:US
Mailing Address - Phone:270-823-4529
Mailing Address - Fax:
Practice Address - Street 1:901 US HIGHWAY 60 E
Practice Address - Street 2:
Practice Address - City:MORGANFIELD
Practice Address - State:KY
Practice Address - Zip Code:42437-6603
Practice Address - Country:US
Practice Address - Phone:270-389-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008767183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist