Mil-Dan, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00378900 Issued in NJ

Legal business name

MIL-DAN, INC

Practice address

215 N Hermitage Ave
Trenton, NJ 08618-5511

Phone

(609) 394-0600

Fax

(609) 394-5505

NPI assigned

Jun 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Miles K Ettman, RPHNPI 1174047450

Title

Pharmacist-in-Charge

Phone

(609) 394-0600

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Westside Pharmacy Doing business as

Locations

Practitioners 2

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

• Miles Kenneth Ettman, RPH

  • Pharmacist
  • Trenton, NJ
  • NPI 1174047450
  NPD (past) Authorized official
• Nileshkumar Amin, RPH

  • Pharmacist
  • Trenton, NJ
  • NPI 1184220261
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226102400000",
    "number": "1679517049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N HERMITAGE AVE",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086185511",
            "telephone_number": "609-394-0600",
            "fax_number": "609-394-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N HERMITAGE AVE",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086185511",
            "telephone_number": "609-394-0600",
            "fax_number": "609-394-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIL-DAN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2008-11-08",
        "status": "A",
        "authorized_official_last_name": "ETTMAN",
        "authorized_official_first_name": "MILES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "609-394-0600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NJ",
            "license": "0125164",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00378900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0125156",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0125164",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westside Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Merritt, DNP, APN, PMHNP, NE
• Gerfrance Metelus-Benjamin, REGISTERED NURSE
• Elizabeth Antonette Meyers, DOULA
• Magdalena Julia Mezynski, P.A.
• Michael J. Holman, MD
• Milestones in Motion Occupational Therapy LLC
• Andrew David Miller, M.D.
• Denise Miller
• Millhill Child & Family Development Corporation
• Millhill Child and Family Development

• Community/Retail Pharmacy in Trenton, NJ
• Providers in Trenton, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.