Provider Demographics
NPI:1700398468
Name:MILLER, SUSAN BROWN (RPH)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:BROWN
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:PO BOX 337
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:SC
Mailing Address - Zip Code:29745-0337
Mailing Address - Country:US
Mailing Address - Phone:803-684-3320
Mailing Address - Fax:
Practice Address - Street 1:822 E LIBERTY ST STE B
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:SC
Practice Address - Zip Code:29745-3501
Practice Address - Country:US
Practice Address - Phone:803-628-7934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4632183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist