Organization
MILLERS PHARMACY INC
Active
Other names
MILLERS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY S CLOUSE PHARMD (PHARMACY MANAGER/PRESIDENT)
(570) 746-1004
Entity
Organization
Contact information
Practice address
RT 6 FARM AND HOME PLAZA, WYALUSING, PA 18853
(570) 746-1004
(570) 746-9470
Mailing address
PO BOX 459, WYALUSING, PA 18853-0459
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP411594L
PA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0077321670003
—
PA
01
—
2080993
PK
—
Enumeration date
04/03/2007
Last updated
07/22/2019
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