Organization
MILLER PROFESSIONAL PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES MICHAEL MILLER RPH (PRESIDENT)
(816) 858-2400
Entity
Organization
Contact information
Practice address
2703 RUNNING HORSE RD STE 1A, #1877, PLATTE CITY, MO 64079-7707
(816) 858-2400
(816) 858-5051
Mailing address
PO BOX 1877, 2703 RUNNING HORSE RD STE 1A, PLATTE CITY, MO 64079-1877
(816) 858-2400
(816) 858-5051
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
PS 005109
MO
333600000X
Pharmacy
Primary
PS005109
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
601155609
—
MO
Enumeration date
03/14/2006
Last updated
10/06/2016
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