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General NPI Number Information
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NPI Number | 1225081052
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Entity Type | Individual
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Provider Name | PATRICIA ELLEN MILLER RPH
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Gender | Female
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 101 E MARKET
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City | TROY
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State | IL
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Zip | 62294
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Country | US
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Telephone | 618-667-6726
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Fax | 618-667-6972
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Provider Business Mailing Address
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Address Line | 7949 GREEN HEDGE RD
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City | EDWARDSVILLE
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State | IL
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Zip | 62025
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Country | US
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Telephone | 618-656-1116
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Fax | 618-659-1816
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051037036
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License Number State | IL
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