Provider Demographics
NPI:1053781724
Name:STROCK, GEORGE (PHARMD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:STROCK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 S 13TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5640
Mailing Address - Country:US
Mailing Address - Phone:844-657-6786
Mailing Address - Fax:267-324-3594
Practice Address - Street 1:249 S 13TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5640
Practice Address - Country:US
Practice Address - Phone:844-657-6786
Practice Address - Fax:267-324-3594
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443990183500000X
PARPI001729183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist