MEDICARE: D&E MILLER ENTERPRISES, 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	261QH0100X	Health Service Clinic/Center	33.014014	OH
2	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1770876310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D&E MILLER ENTERPRISES, INC.

Provider Business Mailing Address
First Line	:	4662 LARWELL DR.
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3621
Country	:	US
Telephone Number	:	614-442-6754
Fax Number	:	614-442-6737

Provider Business Practice Location Address
First Line	:	4662 LARWELL DR.
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3621
Country	:	US
Telephone Number	:	614-442-6754
Fax Number	:	614-442-6737

Authorized Official
Title or Position	:	OWNER
Name	:	ELAINE GASTALDO RITTER
Credential	:	LMT
Telephone Number	:	614-442-6754

Provider Enumeration Date	:	05/16/2011
Last Update Date	:	08/09/2023

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Directions to “D&E MILLER ENTERPRISES, INC. ” Practice Location

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