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General NPI Number Information
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NPI Number | 1982157491
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Entity Type | Individual
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Provider Name | STATEN MILLER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/01/2016
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Last Update Date | 08/01/2016
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Provider Practice Location Address
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Address Line | 254 HIGHWAY 72 BYPASS
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City | GREENWOOD
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State | SC
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Zip | 29649-1509
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Country | US
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Telephone | 864-299-1399
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Fax |
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Provider Business Mailing Address
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Address Line | 544 AUSTIN RD
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City | DONALDS
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State | SC
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Zip | 29638-9078
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Country | US
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Telephone | 864-207-0475
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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 | 36742
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License Number State | SC
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