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General NPI Number Information
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NPI Number | 1073921128
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Entity Type | Organization
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Legal Business Name | ARCHANGEL ONE LLC
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Dates
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Enumeration Date | 07/31/2014
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Last Update Date | 02/14/2017
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Provider Practice Location Address
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Address Line | 11001 SPRING HILL DR
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City | SPRING HILL
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State | FL
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Zip | 34608-5052
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Country | US
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Telephone | 352-610-4355
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Fax | 352-610-4388
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Provider Business Mailing Address
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Address Line | 11001 SPRING HILL DR
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City | SPRING HILL
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State | FL
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Zip | 34608-5052
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Country | US
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Telephone | 352-610-4355
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Fax | 352-610-4388
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Authorized Official
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Title or Position | R.PH. MANAGER/PHARMACY OWNER
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Name | AMIR MESSIHA
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Credential | B.S.
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Telephone | 352-610-4355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH28365
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License Number State | FL
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