Provider Demographics
NPI:1356988166
Name:MILLER, JOSHUA DALE (PHARM D)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DALE
Last Name:MILLER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2856 LONGFELLOW PL APT 245
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7463
Mailing Address - Country:US
Mailing Address - Phone:503-679-1234
Mailing Address - Fax:
Practice Address - Street 1:360 S GARDEN WAY STE 120
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8173
Practice Address - Country:US
Practice Address - Phone:888-973-0498
Practice Address - Fax:541-225-3408
Is Sole Proprietor?:No
Enumeration Date:2019-11-30
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0017629183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist