MEDICARE: BIANCA MILES

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	0202216246	VA

General Provider Information

NPI Number	:	1295248185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BIANCA MILES

Provider Business Mailing Address
First Line	:	1303 JAMESTOWN RD STE 11
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-3407
Country	:	US
Telephone Number	:	757-220-1355
Fax Number	:

Provider Business Practice Location Address
First Line	:	1303 JAMESTOWN RD STE 11
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-3407
Country	:	US
Telephone Number	:	757-220-1355
Fax Number	:

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

Provider Enumeration Date	:	11/14/2017
Last Update Date	:	11/14/2017

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Directions to “ BIANCA MILES ” Practice Location

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