MEDICARE: MEGAN KRISTINE 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	2019025941	MO

General Provider Information

NPI Number	:	1396397154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN KRISTINE MILLER PHARMD

Provider Business Mailing Address
First Line	:	2404 PLEASANT VALLEY DR
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63303-3868
Country	:	US
Telephone Number	:	314-803-8929
Fax Number	:

Provider Business Practice Location Address
First Line	:	1661 JUNGERMANN RD
Second Line	:
City	:	SAINT PETERS
State	:	MO
Zip	:	63304-2821
Country	:	US
Telephone Number	:	636-447-7740
Fax Number	:

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

Provider Enumeration Date	:	07/11/2019
Last Update Date	:	07/11/2019

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