Provider Demographics
NPI:1700902269
Name:MILES, SYLVIA M (RPH)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:M
Last Name:MILES
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 1:426 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26187-1249
Mailing Address - Country:US
Mailing Address - Phone:304-375-6547
Mailing Address - Fax:304-375-6139
Practice Address - Street 1:426 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:WV
Practice Address - Zip Code:26187-1249
Practice Address - Country:US
Practice Address - Phone:304-375-6547
Practice Address - Fax:304-375-6139
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0003678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist