Provider Demographics
NPI:1386900553
Name:MILLER, AMY M (RPH)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:M
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 1:32732 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:MI
Mailing Address - Zip Code:48184-1431
Mailing Address - Country:US
Mailing Address - Phone:734-595-9956
Mailing Address - Fax:734-595-9969
Practice Address - Street 1:32732 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184-1431
Practice Address - Country:US
Practice Address - Phone:734-595-9956
Practice Address - Fax:734-595-9969
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302030290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist