Provider Demographics
NPI:1043725815
Name:MILO, VINCENT ANDREW (RPH)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:ANDREW
Last Name:MILO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-1915
Mailing Address - Country:US
Mailing Address - Phone:860-621-9830
Mailing Address - Fax:860-621-9835
Practice Address - Street 1:235 QUEEN ST
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-1915
Practice Address - Country:US
Practice Address - Phone:860-621-9830
Practice Address - Fax:860-621-9835
Is Sole Proprietor?:No
Enumeration Date:2017-12-02
Last Update Date:2017-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7746183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist