MEDICARE: CHERYL L MILLER 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	37425	CA

General Provider Information

NPI Number	:	1104908037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL L MILLER RPH

Provider Business Mailing Address
First Line	:	4215 TIERRA REJADA RD # 219
Second Line	:
City	:	MOORPARK
State	:	CA
Zip	:	93021-3772
Country	:	US
Telephone Number	:	805-529-3431
Fax Number	:

Provider Business Practice Location Address
First Line	:	5601 DESOTO AVE
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91365
Country	:	US
Telephone Number	:	818-719-4050
Fax Number	:

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

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	07/08/2007

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