MEDICARE: RYAN SCOTT MILLS PHARM.D

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	19259	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457584070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN SCOTT MILLS PHARM.D

Provider Business Mailing Address
First Line	:	311 WOODVALE PL
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28208-4336
Country	:	US
Telephone Number	:	704-458-7088
Fax Number	:

Provider Business Practice Location Address
First Line	:	8450 BELLHAVEN BLVD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28216-6103
Country	:	US
Telephone Number	:	704-392-1369
Fax Number	:

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

Provider Enumeration Date	:	08/30/2009
Last Update Date	:	08/30/2009

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