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General NPI Number Information
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NPI Number | 1295829604
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Entity Type | Organization
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Legal Business Name | MIKE'S PHARMACY, INC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | 2647 INTERNATIONAL BLVD STE 106
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City | OAKLAND
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State | CA
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Zip | 94601-1537
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Country | US
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Telephone | 510-533-4130
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Fax | 510-533-0980
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Provider Business Mailing Address
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Address Line | 2647 INTERNATIONAL BLVD STE 106
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City | OAKLAND
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State | CA
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Zip | 94601-1537
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO AND FOUNDER
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Name | MICHAEL NATALI
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Credential |
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Telephone | 570-533-4130
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY228790
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License Number State | CA
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