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NPI Code Detail

MEDICARE: ALEXANDER MICAEL PHARM.D. RPH

MEDICARE: ALEXANDER MICAEL PHARM.D. RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistS022315AZ

General Provider Information

NPI Number : 1083159826
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDER MICAEL PHARM.D. RPH
Provider Business Mailing Address
First Line : 3450 W DUNLAP AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85051-5302
Country : US
Telephone Number : 602-973-0971
Fax Number :
Provider Business Practice Location Address
First Line : 3450 W DUNLAP AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85051-5302
Country : US
Telephone Number : 602-973-0971
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2017
Last Update Date : 01/04/2017

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