Provider Demographics
NPI:1538252119
Name:LAHR, MILES RICHARD (RPH, CDE)
Entity type:Individual
Prefix:MR
First Name:MILES
Middle Name:RICHARD
Last Name:LAHR
Suffix:
Gender:M
Credentials:RPH, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14359 EMBASSY WAY
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-6466
Mailing Address - Country:US
Mailing Address - Phone:808-635-2883
Mailing Address - Fax:
Practice Address - Street 1:15560 PILOT KNOB RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7286
Practice Address - Country:US
Practice Address - Phone:952-236-3165
Practice Address - Fax:952-236-3165
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN111431183500000X
HIPH436183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist