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General NPI Number Information
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NPI Number | 1104937127
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Entity Type | Individual
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Provider Name | GEORGE H MCKENZIE PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 619 S MARION AVE
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City | LAKE CITY
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State | FL
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Zip | 32025-5808
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Country | US
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Telephone | 386-758-6019
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Fax |
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Provider Business Mailing Address
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Address Line | 5426 NW 33RD ST
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City | GAINESVILLE
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State | FL
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Zip | 32653-1763
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Country | US
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Telephone | 352-381-1860
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS33027
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License Number State | FL
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