Provider Demographics
NPI:1679842868
Name:MILLER, ROBERT G (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:G
Last Name:MILLER
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 1:78 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-1361
Mailing Address - Country:US
Mailing Address - Phone:908-852-3784
Mailing Address - Fax:908-684-3232
Practice Address - Street 1:78 MAIN ST
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-1361
Practice Address - Country:US
Practice Address - Phone:908-852-3784
Practice Address - Fax:908-684-3232
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01717100183500000X
NJ28RJ00447183500000X
MAPH17280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist