MEDICARE: RAQUEL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	5301008266	MI
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2367767	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1144338518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAQUEL INC

Provider Business Mailing Address
First Line	:	43155 W 9 MILE RD
Second Line	:
City	:	NOVI
State	:	MI
Zip	:	48375-4117
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4163 15 MILE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-5400
Country	:	US
Telephone Number	:	586-977-6044
Fax Number	:	586-977-3919

Authorized Official
Title or Position	:	MANAGER PHARMACY SERVICES
Name	:	DAVID VALENTINE
Credential	:
Telephone Number	:	248-348-1570

Provider Enumeration Date	:	08/27/2006
Last Update Date	:	09/11/2025

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Directions to “RAQUEL INC ” Practice Location

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