MEDICARE: MRS. JENNIFER CHARBONNET MILES RPH, BPHARM

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	34970	TX

General Provider Information

NPI Number	:	1861820367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER CHARBONNET MILES RPH, BPHARM

Provider Business Mailing Address
First Line	:	10700 RICHMOND AVE
Second Line	:	SUITE 259
City	:	HOUSTON
State	:	TX
Zip	:	77042-4925
Country	:	US
Telephone Number	:	713-636-3261
Fax Number	:	713-636-9636

Provider Business Practice Location Address
First Line	:	10700 RICHMOND AVE
Second Line	:	SUITE 259
City	:	HOUSTON
State	:	TX
Zip	:	77042-4925
Country	:	US
Telephone Number	:	713-636-3261
Fax Number	:	713-636-9636

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

Provider Enumeration Date	:	10/18/2013
Last Update Date	:	10/18/2013

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