Provider Demographics
NPI:1154515146
Name:GEORGE, DONALD PATICK JR (RPH)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:PATICK
Last Name:GEORGE
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 1:6005 SAINT ELIA CT
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-8034
Mailing Address - Country:US
Mailing Address - Phone:330-519-3699
Mailing Address - Fax:
Practice Address - Street 1:2700 MAHONING AVE NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-2024
Practice Address - Country:US
Practice Address - Phone:330-395-0505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-01
Last Update Date:2007-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03124449183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist