MEDICARE: MRS. ELAINE MILANICH RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	03-3-16145	OH

General Provider Information

NPI Number	:	1053303875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELAINE MILANICH RPH

Provider Business Mailing Address
First Line	:	8442 SETTLERS PSGE
Second Line	:
City	:	BRECKSVILLE
State	:	OH
Zip	:	44141-1732
Country	:	US
Telephone Number	:	440-746-1886
Fax Number	:	440-746-1887

Provider Business Practice Location Address
First Line	:	403 KEN MAR INDUSTRIAL PKWY
Second Line	:
City	:	BROADVIEW HEIGHTS
State	:	OH
Zip	:	44147-2956
Country	:	US
Telephone Number	:	440-717-5001
Fax Number	:	440-717-5015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	07/08/2007

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