MEDICARE: MILLER DRUG CO INC.

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	333600000X	Pharmacy	60002068A	IN

General Provider Information

NPI Number	:	1013992270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLER DRUG CO INC.

Provider Business Mailing Address
First Line	:	540 S LAKE ST
Second Line	:
City	:	GARY
State	:	IN
Zip	:	46403-2473
Country	:	US
Telephone Number	:	219-938-1103
Fax Number	:	219-938-3252

Provider Business Practice Location Address
First Line	:	540 S LAKE ST
Second Line	:
City	:	GARY
State	:	IN
Zip	:	46403-2473
Country	:	US
Telephone Number	:	219-938-1103
Fax Number	:	219-938-3252

Authorized Official
Title or Position	:	PHARMACIST
Name	:	FRANK J PERSIC
Credential	:
Telephone Number	:	219-938-1103

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	08/22/2020

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Directions to “MILLER DRUG CO INC. ” Practice Location

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