Healthcare Provider Details

I. General information

NPI: 1619116787
Provider Name (Legal Business Name): JANICE PATRICIA MILLER PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 03/12/2021
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4312 SANTA RITA ST
EL PASO TX
79902
US

IV. Provider business mailing address

4312 SANTA RITA ST
EL PASO TX
79902-1328
US

V. Phone/Fax

Practice location:
  • Phone: 915-999-2275
  • Fax:
Mailing address:
  • Phone: 915-999-2275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26956
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number26956
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: