Provider Demographics
NPI:1053775569
Name:MILLINGTON, DALE EDWARD (RPH)
Entity type:Individual
Prefix:MR
First Name:DALE
Middle Name:EDWARD
Last Name:MILLINGTON
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 1:7962 OAKHAVEN PL
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-8102
Mailing Address - Country:US
Mailing Address - Phone:317-849-6376
Mailing Address - Fax:317-915-0776
Practice Address - Street 1:7962 OAKHAVEN PL
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-8102
Practice Address - Country:US
Practice Address - Phone:317-849-6376
Practice Address - Fax:317-915-0776
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26019648A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist