Provider Demographics
NPI:1700080314
Name:SICHAK, VAUGHN P (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:VAUGHN
Middle Name:P
Last Name:SICHAK
Suffix:
Gender:M
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 1:8765 CYPRESS GROVE RUN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-1936
Mailing Address - Country:US
Mailing Address - Phone:814-418-1554
Mailing Address - Fax:
Practice Address - Street 1:4215 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2544
Practice Address - Country:US
Practice Address - Phone:919-493-2548
Practice Address - Fax:919-419-2591
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18753183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist