Provider Demographics
NPI:1154001725
Name:MILLS, GITY (RPH)
Entity type:Individual
Prefix:
First Name:GITY
Middle Name:
Last Name:MILLS
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 1:90 OLD FARM RD
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-5541
Mailing Address - Country:US
Mailing Address - Phone:919-308-3773
Mailing Address - Fax:
Practice Address - Street 1:1101 MAIN ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-6828
Practice Address - Country:US
Practice Address - Phone:508-580-3164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24178183500000X
NC16265183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist