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General NPI Number Information
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NPI Number | 1992952725
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Entity Type | Individual
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Provider Name | JACOB R MILLIRON PHARM D
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Gender | Male
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Dates
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Enumeration Date | 08/22/2008
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Last Update Date | 08/22/2008
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Provider Practice Location Address
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Address Line | 299 N BINKLEY ST
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City | SOLDOTNA
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State | AK
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Zip | 99669-7523
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Country | US
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Telephone | 907-262-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 47450 SAINT ANDREWS CT
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City | KENAI
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State | AK
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Zip | 99611-5943
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Country | US
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Telephone | 907-283-8001
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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 | 1655
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License Number State | AK
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