Active NPI
George D Kollias, RPH
- Pharmacist
- Cleveland, OH
National Provider Identifier
1417011248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03218130
- Practice address
- 2351 E 22ND St
St Vincent Charity Hospital
Cleveland, OH 44115-3111 - Phone
- (216) 592-2853
- Fax
- (216) 592-2875
- NPI assigned
- Dec 19, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03218130 | OH | Primary |
Addresses
Primary practice location
2351 E 22ND St
St Vincent Charity Hospital
Cleveland, OH 44115-3111
Mailing address
32246 Dakota Run
Avon Lake, OH 44012-2610
Phone (440) 933-3961
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FV94211 | Other | OH | FLU VACCINE MEDICARE PIN |
| 7649709 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03218130 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417011248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32246 DAKOTA RUN",
"city": "AVON LAKE",
"state": "OH",
"postal_code": "440122610",
"telephone_number": "440-933-3961",
"fax_number": "216-592-2875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2351 E 22ND ST",
"address_2": "ST VINCENT CHARITY HOSPITAL",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441153111",
"telephone_number": "216-592-2853",
"fax_number": "216-592-2875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLLIAS",
"first_name": "GEORGE",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03218130",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLU VACCINE MEDICARE PIN",
"identifier": "FV94211",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7649709",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.