Provider Demographics
NPI:1801955869
Name:MONCILOVICH, MILAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MILAN
Middle Name:
Last Name:MONCILOVICH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 EDMONDS AVE.
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:AL
Mailing Address - Zip Code:19026
Mailing Address - Country:US
Mailing Address - Phone:610-986-3448
Mailing Address - Fax:
Practice Address - Street 1:1600 ROCKLAND ROAD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802
Practice Address - Country:US
Practice Address - Phone:302-651-5711
Practice Address - Fax:302-651-6350
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-00036201835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy