Provider Demographics
NPI:1659090793
Name:MILLER, CARY STEVEN (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:CARY
Middle Name:STEVEN
Last Name:MILLER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:IL
Mailing Address - Zip Code:61542-1114
Mailing Address - Country:US
Mailing Address - Phone:309-251-4550
Mailing Address - Fax:
Practice Address - Street 1:520 W CLINTON ST
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IL
Practice Address - Zip Code:62681-1246
Practice Address - Country:US
Practice Address - Phone:217-322-3383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051034061183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist