Provider Demographics
NPI:1942509112
Name:MILLER, RICHARD S (RPH)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:S
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 1:17 NEEDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-1902
Mailing Address - Country:US
Mailing Address - Phone:609-877-0533
Mailing Address - Fax:866-374-8761
Practice Address - Street 1:17 NEEDWOOD LN
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-1902
Practice Address - Country:US
Practice Address - Phone:609-877-0533
Practice Address - Fax:866-374-8761
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-27
Last Update Date:2011-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01751300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist