Provider Demographics
NPI:1669802781
Name:VESS, GEORGE EDWARD JR (RPH)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:EDWARD
Last Name:VESS
Suffix:JR
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 1:319 CLEVY BUSH DR
Mailing Address - Street 2:
Mailing Address - City:INMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29349-9472
Mailing Address - Country:US
Mailing Address - Phone:864-237-3932
Mailing Address - Fax:864-595-1433
Practice Address - Street 1:319 CLEVY BUSH DR
Practice Address - Street 2:
Practice Address - City:INMAN
Practice Address - State:SC
Practice Address - Zip Code:29349-9472
Practice Address - Country:US
Practice Address - Phone:864-237-3932
Practice Address - Fax:864-595-1433
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5546183500000X
NC8641183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist