Provider Demographics
NPI:1326422569
Name:SILEA, VICTOR (RPH)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:SILEA
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 1:339 E MAPLE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-2593
Mailing Address - Country:US
Mailing Address - Phone:800-858-7393
Mailing Address - Fax:800-858-7394
Practice Address - Street 1:339 E MAPLE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-2593
Practice Address - Country:US
Practice Address - Phone:800-858-7393
Practice Address - Fax:800-858-7394
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032113611835G0303X
PARP4475341835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric