Provider Demographics
NPI:1689401788
Name:MILLER, ANITA PEGRAM (PHARMD)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:PEGRAM
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 CHEROKEE RD
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9267
Mailing Address - Country:US
Mailing Address - Phone:801-503-4936
Mailing Address - Fax:
Practice Address - Street 1:120 MACDOUGALL DRIVE
Practice Address - Street 2:
Practice Address - City:WEST END
Practice Address - State:NC
Practice Address - Zip Code:27376-9342
Practice Address - Country:US
Practice Address - Phone:910-673-7467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-14
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14933183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist