Healthcare Provider Details

I. General information

NPI: 1477612471
Provider Name (Legal Business Name): MILEX DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 12/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 MAIN ST
CALEDONIA NY
14423-1218
US

IV. Provider business mailing address

3130 MAIN ST
CALEDONIA NY
14423-1218
US

V. Phone/Fax

Practice location:
  • Phone: 585-538-6140
  • Fax: 585-538-9681
Mailing address:
  • Phone: 585-538-6140
  • Fax: 585-538-9681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number012690
License Number StateNY

VIII. Authorized Official

Name: JOEL BEGERT
Title or Position: OWNER
Credential: PHRM
Phone: 585-538-6140