MEDICARE: AMEIKA M. MILLER

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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1366831125
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMEIKA M. MILLER

Provider Business Mailing Address
First Line	:	10601 E 15TH ST
Second Line	:
City	:	ARCADIA
State	:	OK
Zip	:	73007-6905
Country	:	US
Telephone Number	:	405-445-1866
Fax Number	:

Provider Business Practice Location Address
First Line	:	6813 N MAY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-3236
Country	:	US
Telephone Number	:	405-445-1866
Fax Number	:	405-445-7485

Authorized Official
Title or Position	:	OWNER/ OPERATOR
Name	:	AMEIKA M. MILLER
Credential	:	RN, CMF
Telephone Number	:	405-445-1866

Provider Enumeration Date	:	01/16/2015
Last Update Date	:	05/28/2015

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