Provider Demographics
NPI:1902029861
Name:ILIOU, GEORGIOS (RPH)
Entity Type:Individual
Prefix:MR
First Name:GEORGIOS
Middle Name:
Last Name:ILIOU
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 1:225 CARL ELLER RD
Mailing Address - Street 2:
Mailing Address - City:MARS HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28754
Mailing Address - Country:US
Mailing Address - Phone:828-680-9569
Mailing Address - Fax:
Practice Address - Street 1:225 CARL ELLER RD
Practice Address - Street 2:
Practice Address - City:MARS HILL
Practice Address - State:NC
Practice Address - Zip Code:28754
Practice Address - Country:US
Practice Address - Phone:828-680-9569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045077183500000X
NC18780183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist