Healthcare Provider Details

I. General information

NPI: 1013567742
Provider Name (Legal Business Name): DANNY CARLTON MILLER JR. RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2019
Last Update Date: 09/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 N MAIN ST
DAYTON OH
45402-1263
US

IV. Provider business mailing address

989 NOLDER DR
LANCASTER OH
43130-8089
US

V. Phone/Fax

Practice location:
  • Phone: 937-531-2316
  • Fax:
Mailing address:
  • Phone: 614-657-3986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03331203
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: