Provider Demographics
NPI:1063018877
Name:MILLMAN, BONNIE (RPH)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:MILLMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1464 BUCK RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-2626
Mailing Address - Country:US
Mailing Address - Phone:215-860-8000
Mailing Address - Fax:215-860-7671
Practice Address - Street 1:1464 BUCK RD
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:18966-2626
Practice Address - Country:US
Practice Address - Phone:215-860-8000
Practice Address - Fax:215-860-7671
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040695L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist