Provider Demographics
NPI:1447638333
Name:OLIVER, VICTORIA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E CLOVERLAND DR
Mailing Address - Street 2:
Mailing Address - City:IRONWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49938-1720
Mailing Address - Country:US
Mailing Address - Phone:906-932-1208
Mailing Address - Fax:906-932-5987
Practice Address - Street 1:1400 E CLOVERLAND DR
Practice Address - Street 2:
Practice Address - City:IRONWOOD
Practice Address - State:MI
Practice Address - Zip Code:49938-1720
Practice Address - Country:US
Practice Address - Phone:906-932-1208
Practice Address - Fax:906-932-5987
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302038716183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist