Individual provider Active NPI

George D Kollias, RPH

  • Pharmacist
  • Cleveland, OH
National Provider Identifier
1417011248
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03218130 Issued in OH
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, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
FV94211OtherOHFLU VACCINE MEDICARE PIN
7649709MedicaidOH

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

LicenseStateTypeSpecialty
03218130OHMDPharmacist

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.

Verify at the official NPI Registry.