Provider Demographics
NPI:1205174810
Name:HOURY, MARLINE R (RPH)
Entity type:Individual
Prefix:MRS
First Name:MARLINE
Middle Name:R
Last Name:HOURY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5451 BOWMAN RD
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210
Mailing Address - Country:US
Mailing Address - Phone:478-477-2455
Mailing Address - Fax:478-477-8775
Practice Address - Street 1:5451 BOWMAN RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-5783
Practice Address - Country:US
Practice Address - Phone:478-477-2455
Practice Address - Fax:478-477-8775
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA17490183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist