MEDICARE: JENNY B MILES PHARM.D.

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	011880	KY
2	183500000X	Pharmacist	26021358A	IN

General Provider Information

NPI Number	:	1427340827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNY B MILES PHARM.D.

Provider Business Mailing Address
First Line	:	1412 COPPER RUN BLVD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40514-2221
Country	:	US
Telephone Number	:	859-223-0701
Fax Number	:

Provider Business Practice Location Address
First Line	:	3735 PALOMAR CENTRE DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40513-1147
Country	:	US
Telephone Number	:	859-223-0701
Fax Number	:

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

Provider Enumeration Date	:	05/04/2011
Last Update Date	:	05/04/2011

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