MEDICARE: MR. VICTOR L WOLFE RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	03317117	OH

General Provider Information

NPI Number	:	1457192817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VICTOR L WOLFE RPH

Provider Business Mailing Address
First Line	:	9864 SILICA RD
Second Line	:
City	:	NORTH JACKSON
State	:	OH
Zip	:	44451-9685
Country	:	US
Telephone Number	:	330-718-0647
Fax Number	:

Provider Business Practice Location Address
First Line	:	9864 SILICA RD
Second Line	:
City	:	NORTH JACKSON
State	:	OH
Zip	:	44451-9685
Country	:	US
Telephone Number	:	330-718-0647
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2024
Last Update Date	:	06/01/2024

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