Provider Demographics
NPI:1982971818
Name:SLIVOCHKA, RAY MICHAEL (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:RAY
Middle Name:MICHAEL
Last Name:SLIVOCHKA
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:MR
Other - First Name:RAMOND
Other - Middle Name:M
Other - Last Name:SLIVOCHKA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:5501 MAHONING AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2316
Mailing Address - Country:US
Mailing Address - Phone:330-799-8557
Mailing Address - Fax:330-792-6407
Practice Address - Street 1:5501 MAHONING AVE
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2316
Practice Address - Country:US
Practice Address - Phone:330-799-8557
Practice Address - Fax:330-792-6407
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03208010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist