Healthcare Provider Details

I. General information

NPI: 1194932863
Provider Name (Legal Business Name): GEORGE A GEHA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 BOWEN ST
CLAREMONT NH
03743-2329
US

IV. Provider business mailing address

129 RYDER CORNER RD
SUNAPEE NH
03782-2815
US

V. Phone/Fax

Practice location:
  • Phone: 603-542-3325
  • Fax: 603-542-1281
Mailing address:
  • Phone: 603-763-3272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberR1515
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: