MEDICARE: MR. JEFFREY JAY MILLER R.PH.

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	5302024039	MI

General Provider Information

NPI Number	:	1831132448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY JAY MILLER R.PH.

Provider Business Mailing Address
First Line	:	245 S. SECOND ST.
Second Line	:	PO BOX 879
City	:	CARSON CITY
State	:	MI
Zip	:	48811-9504
Country	:	US
Telephone Number	:	989-584-3272
Fax Number	:	989-584-0541

Provider Business Practice Location Address
First Line	:	245 S. SECOND ST.
Second Line	:
City	:	CARSON CITY
State	:	MI
Zip	:	48811-9504
Country	:	US
Telephone Number	:	989-584-3272
Fax Number	:	989-584-0541

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	07/24/2007

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