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NPI Code Detail

MEDICARE: LUCY M MILLER

MEDICARE: LUCY M MILLER
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
1183500000XPharmacist5302411008MI

General Provider Information

NPI Number : 1619267473
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCY M MILLER
Provider Business Mailing Address
First Line : 418 W KALAMAZOO AVE
Second Line :
City : KALAMAZOO
State : MI
Zip : 49007-3334
Country : US
Telephone Number : 269-553-6000
Fax Number : 269-492-9362
Provider Business Practice Location Address
First Line : 418 W KALAMAZOO AVE
Second Line :
City : KALAMAZOO
State : MI
Zip : 49007-3334
Country : US
Telephone Number : 269-553-6000
Fax Number : 269-492-9362
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2011
Last Update Date : 02/09/2015

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