MEDICARE: DR. MERRILL CUSHING MILLER III RPH, PHD

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	10997	NC

General Provider Information

NPI Number	:	1962519819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MERRILL CUSHING MILLER III RPH, PHD

Provider Business Mailing Address
First Line	:	1200 BATCHELOR RD
Second Line	:
City	:	APEX
State	:	NC
Zip	:	27523-5720
Country	:	US
Telephone Number	:	919-367-0795
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 BATCHELOR RD
Second Line	:
City	:	APEX
State	:	NC
Zip	:	27523-5720
Country	:	US
Telephone Number	:	919-367-0795
Fax Number	:

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	07/08/2007

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