Provider Demographics
NPI:1104110949
Name:MILLER, AMY ELIZABETH (RPH)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:MILLER
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 1:5584 DRESSLER RD NW
Mailing Address - Street 2:T-0794
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-7757
Mailing Address - Country:US
Mailing Address - Phone:330-494-4098
Mailing Address - Fax:
Practice Address - Street 1:5584 DRESSLER RD NW
Practice Address - Street 2:T-0794
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-7757
Practice Address - Country:US
Practice Address - Phone:330-494-4098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03122313183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist