Healthcare Provider Details

I. General information

NPI: 1083453732
Provider Name (Legal Business Name): MILLER PRINCIPLE MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2024
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 HIGHWAY 71 BYPASS SOUTH
WALDRON AR
72958
US

IV. Provider business mailing address

6315 HICKORY LN
FORT SMITH AR
72916-8841
US

V. Phone/Fax

Practice location:
  • Phone: 479-637-0222
  • Fax: 479-637-0330
Mailing address:
  • Phone: 870-253-9646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. HOWARD OLIN MILLER
Title or Position: OWNER
Credential: RPH
Phone: 870-253-9646