MEDICARE: COURTNEY RENEE MILLER PHARMD

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	S014257	AZ

General Provider Information

NPI Number	:	1043721509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY RENEE MILLER PHARMD

Provider Business Mailing Address
First Line	:	10240 N 31ST AVE STE 210
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85051-9565
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10240 N 31ST AVE STE 210
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85051-9565
Country	:	US
Telephone Number	:	602-384-9992
Fax Number	:

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

Provider Enumeration Date	:	10/23/2017
Last Update Date	:	10/23/2017

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Directions to “ COURTNEY RENEE MILLER PHARMD” Practice Location

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