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General NPI Number Information
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NPI Number | 1790380939
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Entity Type | Individual
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Provider Name | GARLAND OTIS MILES PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/04/2020
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Last Update Date | 12/04/2020
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Provider Practice Location Address
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Address Line | 31ST AND CENTRAL
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City | KEARNEY
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State | NE
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Zip | 68847
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Country | US
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Telephone | 308-865-7021
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Fax |
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Provider Business Mailing Address
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Address Line | 305 RAINBOW LANE
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City | GIBBON
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State | NE
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Zip | 68840
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Country | US
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Telephone | 308-627-3971
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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 | 9143
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License Number State | NE
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