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NPI Code Detail

MEDICARE: MS. MEGAN M MILTZ

MEDICARE: MS. MEGAN M MILTZ
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
1183500000XPharmacist26019686AIN

General Provider Information

NPI Number : 1790911881
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MEGAN M MILTZ
Provider Business Mailing Address
First Line : 5150 FRANKLIN ST
Second Line :
City : MICHIGAN CITY
State : IN
Zip : 46360-7878
Country : US
Telephone Number : 219-877-2464
Fax Number : 219-877-2465
Provider Business Practice Location Address
First Line : 5150 FRANKLIN ST
Second Line :
City : MICHIGAN CITY
State : IN
Zip : 46360-7878
Country : US
Telephone Number : 219-877-2464
Fax Number : 219-877-2465
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2009
Last Update Date : 06/03/2009

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