Healthcare Provider Details

I. General information

NPI: 1003753211
Provider Name (Legal Business Name): RICHARD MILLER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 HIGH ST STE 3
LOCK HAVEN PA
17745-3029
US

IV. Provider business mailing address

529 HIGH ST STE 3
LOCK HAVEN PA
17745-3029
US

V. Phone/Fax

Practice location:
  • Phone: 570-560-4227
  • Fax:
Mailing address:
  • Phone: 570-560-4227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number92583601
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: