Healthcare Provider Details

I. General information

NPI: 1689676447
Provider Name (Legal Business Name): GEORGE L PAPPAS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 02/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2145 ROOSEVELT AVE
SPRINGFIELD MA
01104-1650
US

IV. Provider business mailing address

76 MACARTHUR DR
MILLBURY MA
01527-3547
US

V. Phone/Fax

Practice location:
  • Phone: 413-504-4492
  • Fax:
Mailing address:
  • Phone: 413-504-4492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9456
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17660
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number17660
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number9456
License Number StateCT
# 5
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number17660
License Number StateMA
# 6
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number9456
License Number StateCT
# 7
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number17660
License Number StateMA
# 8
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number9456
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: