Provider Demographics
NPI:1598048209
Name:MILLER, DEBRA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:
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 1:1202 W UNION AVE
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62056-1165
Mailing Address - Country:US
Mailing Address - Phone:217-324-7670
Mailing Address - Fax:217-324-7676
Practice Address - Street 1:1202 W UNION AVE
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:IL
Practice Address - Zip Code:62056-1165
Practice Address - Country:US
Practice Address - Phone:217-324-7670
Practice Address - Fax:217-324-7676
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051034583183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist