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General NPI Number Information
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NPI Number | 1316304611
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Entity Type | Organization
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Legal Business Name | ARCHANGEL MICHAEL PHARMACY INC
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Dates
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Enumeration Date | 01/19/2016
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 31754 TEMECULA PKWY STE D
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City | TEMECULA
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State | CA
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Zip | 92592-6805
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Country | US
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Telephone | 951-302-7733
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Fax | 951-302-7717
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Provider Business Mailing Address
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Address Line | 31754 TEMECULA PKWY STE D
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City | TEMECULA
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State | CA
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Zip | 92592-6805
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Country | US
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Telephone | 951-302-7733
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Fax | 951-302-7717
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Authorized Official
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Title or Position | OWNER/CEO/AO/PIC
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Name | MARY GALEY
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Credential |
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Telephone | 951-302-7733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY54283
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License Number State | CA
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