=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326447343
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHELLE BUDMAN RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2014
-----------------------------------------------------
Last Update Date | 08/14/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 34220 MONTEREY AVE
-----------------------------------------------------
City | PALM DESERT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92211-2096
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-770-9622
-----------------------------------------------------
Fax | 760-770-8853
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 34220 MONTEREY AVE
-----------------------------------------------------
City | PALM DESERT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92211-2096
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-770-9622
-----------------------------------------------------
Fax | 760-770-8853
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 45877
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------