Healthcare Provider Details

I. General information

NPI: 1629131248
Provider Name (Legal Business Name): MILLERS PHARMACY OF FARMINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 06/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6181 ROUTE 96
FARMINGTON NY
14425-1004
US

IV. Provider business mailing address

6181 ROUTE 96
FARMINGTON NY
14425-1004
US

V. Phone/Fax

Practice location:
  • Phone: 585-924-1676
  • Fax: 585-924-8763
Mailing address:
  • Phone: 585-924-1676
  • Fax: 585-924-8763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number024495
License Number StateNY

VIII. Authorized Official

Name: DANIEL MILLER
Title or Position: PRES
Credential:
Phone: 585-924-1676