Healthcare Provider Details

I. General information

NPI: 1609474402
Provider Name (Legal Business Name): ROBBY GEORGE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1227 ROCKBRIDGE RD
STONE MOUNTAIN GA
30087-3064
US

IV. Provider business mailing address

1324 CRESENT CIR SW
LILBURN GA
30047-2304
US

V. Phone/Fax

Practice location:
  • Phone: 770-225-1888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH029283
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: