NPIMap

Organization Active NPI

Millers Pharmacy Inc

  • Community/Retail Pharmacy
  • Wyalusing, PA
National Provider Identifier
1467573840
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP411594L Issued in PA
Legal business name
MILLERS PHARMACY INC
Practice address
RT 6 Farm and Home Plaza
Wyalusing, PA 18853
Phone
(570) 746-1004
Fax
(570) 746-9470
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kimberly S Clouse, PHARMDNPI 1194027086
Title
Pharmacy Manager/President
Phone
(570) 746-1004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PP411594L PA Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

RT 6 Farm and Home Plaza
Wyalusing, PA 18853

Mailing address

PO Box 459
Wyalusing, PA 18853-0459

Other identifiers 2

IdentifierTypeStateIssuer
2080993OtherPK
0077321670003MedicaidPA

Other names 1

  • MILLERS PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930066185 PA DME Supplier - Pharmacy 2567573801 Practice locations: Wyalusing, PA
O20181213000921 PA Part B Supplier - Mass Immunization (Roster Biller Only) 2567573801 Practice locations: Wyalusing, PA

National Provider Directory

National Provider Directory
Tax ID family
Millers Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563753600000",
    "number": "1467573840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "WYALUSING",
            "state": "PA",
            "postal_code": "188530459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RT 6 FARM AND HOME PLAZA",
            "city": "WYALUSING",
            "state": "PA",
            "postal_code": "18853",
            "telephone_number": "570-746-1004",
            "fax_number": "570-746-9470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLERS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2019-07-22",
        "status": "A",
        "authorized_official_last_name": "CLOUSE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHARMACY MANAGER/PRESIDENT",
        "authorized_official_telephone_number": "570-746-1004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP411594L",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2080993",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0077321670003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MILLERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MILLERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wyalusing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.