Provider Demographics
NPI:1992097877
Name:MILLER, PAUL EUGENE (RPH)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:EUGENE
Last Name:MILLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 LAUREL PLZ
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18640-3546
Mailing Address - Country:US
Mailing Address - Phone:570-655-9920
Mailing Address - Fax:
Practice Address - Street 1:120 LAUREL PLZ
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18640-3546
Practice Address - Country:US
Practice Address - Phone:570-655-9920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP033341L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist