Provider Demographics
NPI:1851397996
Name:MILLER, JOHN RAYMOND (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:RAYMOND
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 1:5234 SAVINA AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-1138
Mailing Address - Country:US
Mailing Address - Phone:937-836-6797
Mailing Address - Fax:
Practice Address - Street 1:101 WYOMING ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2732
Practice Address - Country:US
Practice Address - Phone:937-208-4889
Practice Address - Fax:937-341-8349
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-167911835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy