Provider Demographics
NPI:1578163473
Name:CIARAMITARO, VICTOR LOUIS (RPH)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:LOUIS
Last Name:CIARAMITARO
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 1:10197 SIMMS STATION RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-9527
Mailing Address - Country:US
Mailing Address - Phone:937-885-5806
Mailing Address - Fax:
Practice Address - Street 1:8800 KINGSRIDGE DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-1616
Practice Address - Country:US
Practice Address - Phone:937-435-8533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03216744183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist