Provider Demographics
NPI:1841572443
Name:MILLER, JOHN A (RPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:MILLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30182 SUSSEX HWY UNIT 1
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:DE
Mailing Address - Zip Code:19956-3884
Mailing Address - Country:US
Mailing Address - Phone:302-875-8560
Mailing Address - Fax:302-875-8566
Practice Address - Street 1:30182 SUSSEX HWY UNIT 1
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:DE
Practice Address - Zip Code:19956-3884
Practice Address - Country:US
Practice Address - Phone:302-875-8560
Practice Address - Fax:302-875-8566
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0002591183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist