Provider Demographics
NPI:1770760647
Name:MILBURN, JOHN F (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:MILBURN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 WALLFLOWER DRIVE
Mailing Address - Street 2:
Mailing Address - City:REXFORD
Mailing Address - State:NY
Mailing Address - Zip Code:12148-1522
Mailing Address - Country:US
Mailing Address - Phone:518-371-2845
Mailing Address - Fax:
Practice Address - Street 1:47 WALLFLOWER DR
Practice Address - Street 2:
Practice Address - City:REXFORD
Practice Address - State:NY
Practice Address - Zip Code:12148-1522
Practice Address - Country:US
Practice Address - Phone:518-371-2845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist