Provider Demographics
NPI:1073816633
Name:MYLES, DONALD J (RPH)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:MYLES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MACINTOSH DR
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-9474
Mailing Address - Country:US
Mailing Address - Phone:856-478-2179
Mailing Address - Fax:856-455-9462
Practice Address - Street 1:500 MACINTOSH DR
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-9474
Practice Address - Country:US
Practice Address - Phone:856-478-2179
Practice Address - Fax:856-455-9462
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01927500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist