Healthcare Provider Details

I. General information

NPI: 1548574395
Provider Name (Legal Business Name): AMANDA LEE MILLER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2010
Last Update Date: 08/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 EAST BLVD PHARMACY SERVICE 119W
CLEVELAND OH
44106-1702
US

IV. Provider business mailing address

10701 EAST BLVD PHARMACY SERVICE 119W
CLEVELAND OH
44106-1702
US

V. Phone/Fax

Practice location:
  • Phone: 216-791-3800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03129577
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: