Provider Demographics
NPI:1417367905
Name:SISLER, HEATHER (RPH)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:SISLER
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 1:8300 MEIJER DR
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-7400
Mailing Address - Country:US
Mailing Address - Phone:614-920-7210
Mailing Address - Fax:
Practice Address - Street 1:8300 MEIJER DR
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-7400
Practice Address - Country:US
Practice Address - Phone:614-920-7210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03221404183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist