Provider Demographics
NPI:1750557757
Name:MILLER, WILLIAM E JR (RPH)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:MILLER
Suffix:JR
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 1:125 MALLARD ST
Mailing Address - Street 2:STE. C
Mailing Address - City:SAINT ROSE
Mailing Address - State:LA
Mailing Address - Zip Code:70087-4020
Mailing Address - Country:US
Mailing Address - Phone:800-225-5967
Mailing Address - Fax:909-799-4364
Practice Address - Street 1:125 MALLARD ST
Practice Address - Street 2:STE. C
Practice Address - City:SAINT ROSE
Practice Address - State:LA
Practice Address - Zip Code:70087-4020
Practice Address - Country:US
Practice Address - Phone:800-225-5967
Practice Address - Fax:909-799-4364
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA011794183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist