Provider Demographics
NPI:1063102630
Name:MILLER, SAHM Q (CPHT)
Entity type:Individual
Prefix:
First Name:SAHM
Middle Name:Q
Last Name:MILLER
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:881 REVERE VILLAGE CT APT A
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-3415
Mailing Address - Country:US
Mailing Address - Phone:440-488-1057
Mailing Address - Fax:
Practice Address - Street 1:898 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-3439
Practice Address - Country:US
Practice Address - Phone:937-433-4909
Practice Address - Fax:937-434-9972
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10013385183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician