# MR. GEORGE JOSEPH HAVENS III

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1114354214
- **Gender:** Man
- **Credential:** RPH

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | 051.036002 | IL | — |
| 183500000X | Pharmacist | PHA-PHA-LIC-15025 | MT | Yes |
| 183500000X | Pharmacist | PHA.0019838 | CO | — |

## Other

- **Enumeration date:** 10/03/2013
- **Last updated:** 07/30/2014