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General NPI Number Information
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NPI Number | 1598565897
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Entity Type | Organization
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Legal Business Name | ARCHANGEL PHARMACY LLC
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 7306 STATE ROAD 52 STE 4
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City | HUDSON
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State | FL
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Zip | 34667-6750
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Country | US
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Telephone | 727-300-2087
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Fax | 727-300-2087
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Provider Business Mailing Address
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Address Line | 7306 STATE ROAD 52 STE 4
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City | HUDSON
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State | FL
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Zip | 34667-6750
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Country | US
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Telephone | 727-300-2087
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Fax | 727-300-2087
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL IBRAHIM
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Credential |
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Telephone | 646-280-9084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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