Healthcare Provider Details

I. General information

NPI: 1932410701
Provider Name (Legal Business Name): MR. EHOR GEORGE FLUNT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2010
Last Update Date: 06/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924-40 FAIRMOUNT AVE
PHILADELPHIA PA
19130
US

IV. Provider business mailing address

3 TENBY CHASE DR
VOORHEES NJ
08043-2959
US

V. Phone/Fax

Practice location:
  • Phone: 215-765-5078
  • Fax:
Mailing address:
  • Phone: 856-809-9989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP032306L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: