Healthcare Provider Details

I. General information

NPI: 1871789990
Provider Name (Legal Business Name): BRIAN K MILES RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2007
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 MARKET ST
BROWNSVILLE PA
15417-1787
US

IV. Provider business mailing address

PO BOX 98
EIGHTY FOUR PA
15330-0098
US

V. Phone/Fax

Practice location:
  • Phone: 724-785-7095
  • Fax:
Mailing address:
  • Phone: 724-222-2512
  • Fax: 724-222-2527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP040917L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: