Individual
MR. CHARLES W MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
510 E STONER AVE DEPT 119, SHREVEPORT, LA 71101-4243
(318) 221-8411
(318) 429-5750
Mailing address
2111 COUNTY ROAD 4670, ATLANTA, TX 75551-7813
(903) 796-9372
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
30787
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30787
PHARMACIST LICENSE NUMBER
TX
Enumeration date
08/11/2006
Last updated
07/08/2007
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