Provider Demographics
NPI:1457192817
Name:WOLFE, VICTOR L (RPH)
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:L
Last Name:WOLFE
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 1:9864 SILICA RD
Mailing Address - Street 2:
Mailing Address - City:NORTH JACKSON
Mailing Address - State:OH
Mailing Address - Zip Code:44451-9685
Mailing Address - Country:US
Mailing Address - Phone:330-718-0647
Mailing Address - Fax:
Practice Address - Street 1:9864 SILICA RD
Practice Address - Street 2:
Practice Address - City:NORTH JACKSON
Practice Address - State:OH
Practice Address - Zip Code:44451-9685
Practice Address - Country:US
Practice Address - Phone:330-718-0647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-01
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03317117183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist