Provider Demographics
NPI:1164656302
Name:SILKA, MOLLY (RPH)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:SILKA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3057 DEAN RD
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-9695
Mailing Address - Country:US
Mailing Address - Phone:419-708-0916
Mailing Address - Fax:419-893-5158
Practice Address - Street 1:7358 SECOR RD
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:MI
Practice Address - Zip Code:48144-9737
Practice Address - Country:US
Practice Address - Phone:734-856-7984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-02
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-26267183500000X
MI5302046337183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist