Provider Demographics
NPI:1679825913
Name:MILLER, ANDREW J (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
Last Name:MILLER
Suffix:
Gender:M
Credentials:PHARMD
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Mailing Address - Street 1:6420 CLAYTON RD
Mailing Address - Street 2:DEPT OF PHARMACY
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1811
Mailing Address - Country:US
Mailing Address - Phone:314-768-8348
Mailing Address - Fax:314-768-8956
Practice Address - Street 1:6420 CLAYTON RD
Practice Address - Street 2:DEPT OF PHARMACY
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63117-1811
Practice Address - Country:US
Practice Address - Phone:314-768-8348
Practice Address - Fax:314-768-8956
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2015-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL051.292028183500000X
MO2010014031183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist