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General NPI Number Information
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NPI Number | 1558565432
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Entity Type | Individual
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Provider Name | CHARLES MICHAEL MILLER RPH
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Gender | Male
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 2703 RUNNING HORSE RD STE 1A #1877
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City | PLATTE CITY
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State | MO
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Zip | 64079-7707
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Country | US
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Telephone | 816-858-2400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1877 2703 RUNNING HORSE RD STE 1A
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City | PLATTE CITY
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State | MO
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Zip | 64079-1877
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Country | US
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Telephone | 816-858-2400
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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 | PS005109
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License Number State | MO
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