Provider Demographics
NPI:1316574106
Name:MILLER, TASHA LYNN HARMON (RPH)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:LYNN HARMON
Last Name:MILLER
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 1:5155 ELDERTON DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-8908
Mailing Address - Country:US
Mailing Address - Phone:319-651-6559
Mailing Address - Fax:319-393-2915
Practice Address - Street 1:2645 BLAIRS FERRY RD NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-1802
Practice Address - Country:US
Practice Address - Phone:319-393-2110
Practice Address - Fax:319-393-2915
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18824183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist