Healthcare Provider Details

I. General information

NPI: 1699924464
Provider Name (Legal Business Name): AMANDA MARIE MILLER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2008
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 REYNOLDS RD
MAUMEE OH
43537-1625
US

IV. Provider business mailing address

1435 REYNOLDS RD
MAUMEE OH
43537-1625
US

V. Phone/Fax

Practice location:
  • Phone: 567-302-2689
  • Fax: 567-302-2691
Mailing address:
  • Phone: 567-302-2689
  • Fax: 567-302-2691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03328649
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: