Provider Demographics
NPI:1366831125
Name:AMEIKA M. MILLER
Entity Type:Organization
Organization Name:AMEIKA M. MILLER
Other - Org Name:COURAGE CLOSET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMEIKA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CMF
Authorized Official - Phone:405-445-1866
Mailing Address - Street 1:10601 E 15TH ST
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:OK
Mailing Address - Zip Code:73007-6905
Mailing Address - Country:US
Mailing Address - Phone:405-445-1866
Mailing Address - Fax:
Practice Address - Street 1:6813 N MAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-3236
Practice Address - Country:US
Practice Address - Phone:405-445-1866
Practice Address - Fax:405-445-7485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-16
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment