Provider Demographics
NPI:1225047178
Name:VENA, VICTOR ANTHONY (RPH)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:ANTHONY
Last Name:VENA
Suffix:
Gender:M
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:VIC VENA PHARMACY
Mailing Address - Street 2:1322 WEST STATE STREET
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760
Mailing Address - Country:US
Mailing Address - Phone:716-372-7761
Mailing Address - Fax:
Practice Address - Street 1:1322 WEST STATE STREET
Practice Address - Street 2:VIC VENA PHARMACY
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760
Practice Address - Country:US
Practice Address - Phone:716-372-7761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY03035011835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy