Healthcare Provider Details

I. General information

NPI: 1073822615
Provider Name (Legal Business Name): CARRIE LYNN MILLER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2010
Last Update Date: 06/28/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 ROSS ST
ELGIN SC
29045
US

IV. Provider business mailing address

1830 PORTER CROSS RD
LUGOFF SC
29078-9658
US

V. Phone/Fax

Practice location:
  • Phone: 803-438-5735
  • Fax: 803-435-4657
Mailing address:
  • Phone: 803-319-7288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20032
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202007813
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8766
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: