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General NPI Number Information
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NPI Number | 1396948907
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Entity Type | Individual
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Provider Name | MARY GEORGE HEARD RPH
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Gender | Female
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Dates
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Enumeration Date | 06/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7950 MARTIN LOOP
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City | FORT BENNING
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State | GA
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Zip | 31905-5647
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Country | US
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Telephone | 706-544-4666
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Fax |
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Provider Business Mailing Address
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Address Line | 604 MCCRARY RD
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City | FORTSON
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State | GA
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Zip | 31808-4506
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Country | US
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Telephone | 706-653-8264
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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 | 16479
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License Number State | GA
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