Provider Demographics
NPI:1861056418
Name:OVERMILLER, DEAN J (PHARMD)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:J
Last Name:OVERMILLER
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 1:273 OLD LITTLETON RD
Mailing Address - Street 2:
Mailing Address - City:HARVARD
Mailing Address - State:MA
Mailing Address - Zip Code:01451-1422
Mailing Address - Country:US
Mailing Address - Phone:919-597-0915
Mailing Address - Fax:
Practice Address - Street 1:42 PATTON RD
Practice Address - Street 2:
Practice Address - City:AYER
Practice Address - State:MA
Practice Address - Zip Code:01434-3802
Practice Address - Country:US
Practice Address - Phone:978-796-1560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC173391835P1200X
MAE0912401146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic