Provider Demographics
NPI:1104353861
Name:MILLER, PAIGE (PHARMD)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 FAIRFAX PIKE
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-3252
Mailing Address - Country:US
Mailing Address - Phone:540-869-4130
Mailing Address - Fax:540-869-0861
Practice Address - Street 1:701 FAIRFAX PIKE
Practice Address - Street 2:
Practice Address - City:STEPHENS CITY
Practice Address - State:VA
Practice Address - Zip Code:22655-3252
Practice Address - Country:US
Practice Address - Phone:540-869-4130
Practice Address - Fax:540-869-0861
Is Sole Proprietor?:No
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202215086183500000X
WVRP0009969183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist