Provider Demographics
NPI:1528551983
Name:WIFF, ROY (RPH)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:
Last Name:WIFF
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 1:6031 STEWARD RD
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:OH
Mailing Address - Zip Code:43021-9017
Mailing Address - Country:US
Mailing Address - Phone:614-439-9079
Mailing Address - Fax:
Practice Address - Street 1:6031 STEWARD RD
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:OH
Practice Address - Zip Code:43021-9017
Practice Address - Country:US
Practice Address - Phone:614-439-9079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03218097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03218097OtherSTATE OF OHIO PHARMACY BOARD