Provider Demographics
NPI:1265810717
Name:HILL, GEORGE II
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:HILL
Suffix:II
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 1:23200 FRONT BEACH RD
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32413-1012
Mailing Address - Country:US
Mailing Address - Phone:850-235-0036
Mailing Address - Fax:850-235-0038
Practice Address - Street 1:23200 FRONT BEACH RD
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32413-1012
Practice Address - Country:US
Practice Address - Phone:850-235-0036
Practice Address - Fax:850-235-0038
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-15
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS13263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist