Basic Information
| Provider Information | |||||||||
| NPI: | 1851762744 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | CAROL | ||||||||
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| Credential: | RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8221 WILLOW OAKS CORPORATE DR | ||||||||
| Address2: | GENOA, A QOL HEALTHCARE COMPANY | ||||||||
| City: | FAIRFAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220314512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038520041 | ||||||||
| FaxNumber: | 7032892790 | ||||||||
| Practice Location | |||||||||
| Address1: | 8221 WILLOW OAKS CORPORATE DR | ||||||||
| Address2: | GENOA, A QOL HEALTHCARE COMPANY | ||||||||
| City: | FAIRFAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220314512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038520041 | ||||||||
| FaxNumber: | 7032892790 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2015 | ||||||||
| LastUpdateDate: | 10/17/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 0202208183 | VA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.