Provider Demographics
NPI:1134717457
Name:KREMENETS, GEORGE
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:KREMENETS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:394 APPLE DR
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2163
Mailing Address - Country:US
Mailing Address - Phone:215-432-7846
Mailing Address - Fax:
Practice Address - Street 1:3425 SCHUYLKILL RD
Practice Address - Street 2:
Practice Address - City:SPRING CITY
Practice Address - State:PA
Practice Address - Zip Code:19475-1138
Practice Address - Country:US
Practice Address - Phone:610-792-2061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-03
Last Update Date:2021-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP454480183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist