Healthcare Provider Details

I. General information

NPI: 1699847228
Provider Name (Legal Business Name): MILLS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 03/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 WESSEL DR
FAIRFIELD OH
45014-3600
US

IV. Provider business mailing address

640 WESSEL DR
FAIRFIELD OH
45014-3600
US

V. Phone/Fax

Practice location:
  • Phone: 513-868-6397
  • Fax: 513-868-9786
Mailing address:
  • Phone: 513-868-6397
  • Fax: 513-868-9786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberRTP.021361050-03
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA WEISENBERGER
Title or Position: PRES
Credential: RPH
Phone: 513-868-6397