Healthcare Provider Details

I. General information

NPI: 1861722167
Provider Name (Legal Business Name): BRIAN PAUL MILLIGAN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2010
Last Update Date: 12/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

IV. Provider business mailing address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

V. Phone/Fax

Practice location:
  • Phone: 800-324-8387
  • Fax: 542-379-4139
Mailing address:
  • Phone: 800-324-8387
  • Fax: 542-379-4139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH18407
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: