MEDICARE: ARYA SUSAN GEORGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP450985	PA

General Provider Information

NPI Number	:	1770033797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARYA SUSAN GEORGE

Provider Business Mailing Address
First Line	:	11025 GREINER RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19116-2611
Country	:	US
Telephone Number	:	267-338-9731
Fax Number	:

Provider Business Practice Location Address
First Line	:	8130 ROOSEVELT BLVD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-2911
Country	:	US
Telephone Number	:	215-331-0160
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2016
Last Update Date	:	10/13/2016

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Directions to “ ARYA SUSAN GEORGE ” Practice Location

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