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General NPI Number Information
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NPI Number | 1548576978
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Entity Type | Individual
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Provider Name | KEVIN THOMAS MILLER R.PH.
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Gender | Male
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Dates
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Enumeration Date | 08/23/2010
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Last Update Date | 03/14/2019
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Provider Practice Location Address
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Address Line | 759 CHESTNUT ST
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City | SPRINGFIELD
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State | MA
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Zip | 01199-4714
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Country | US
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Telephone | 413-794-2197
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Fax |
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Provider Business Mailing Address
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Address Line | 10 ADAMS RD
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City | TOWNSEND
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State | MA
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Zip | 01469-1137
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Country | US
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Telephone | 978-597-2693
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Fax |
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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 | 2978
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 22850
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License Number State | MA
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