Healthcare Provider Details

I. General information

NPI: 1306761531
Provider Name (Legal Business Name): MICHAEL ALFRED MILLER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3804 EASTSIDE HWY
STEVENSVILLE MT
59870-2224
US

IV. Provider business mailing address

218 MCLEOD AVE
MISSOULA MT
59801-4304
US

V. Phone/Fax

Practice location:
  • Phone: 406-777-5002
  • Fax: 406-777-6924
Mailing address:
  • Phone:
  • Fax: 406-777-5002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA-PHA-LIC-107689
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: