Provider Demographics
NPI:1619278843
Name:SILVAS, VALERIE A (PHARM D)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:A
Last Name:SILVAS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3990 STOCKTON HILL RD
Mailing Address - Street 2:F-271
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-3024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4823 SOUTH HWY 95
Practice Address - Street 2:PHARMACY
Practice Address - City:FT. MOHAVE
Practice Address - State:AZ
Practice Address - Zip Code:86427
Practice Address - Country:US
Practice Address - Phone:928-704-4443
Practice Address - Fax:928-704-1684
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS012636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist