Provider Demographics
NPI:1225207061
Name:KOFEL, GEORGE A (RPH)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:A
Last Name:KOFEL
Suffix:
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 1:347 S BLAKELY ST
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-2254
Mailing Address - Country:US
Mailing Address - Phone:570-342-9138
Mailing Address - Fax:570-342-8836
Practice Address - Street 1:347 S BLAKELY ST
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-2254
Practice Address - Country:US
Practice Address - Phone:570-342-9138
Practice Address - Fax:570-342-8836
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030688L183500000X
NY049072-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist