MEDICARE: MICHAEL'S PHARMACY

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	183500000X	Pharmacist	PHY24324	CA

General Provider Information

NPI Number	:	1407844632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL'S PHARMACY

Provider Business Mailing Address
First Line	:	960 E GREEN ST
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-2401
Country	:	US
Telephone Number	:	626-793-7131
Fax Number	:	626-793-8602

Provider Business Practice Location Address
First Line	:	960 E GREEN ST
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-2401
Country	:	US
Telephone Number	:	626-793-7131
Fax Number	:	626-793-8602

Authorized Official
Title or Position	:	OWNER/PHARMACUST
Name	:	MR. MICHAEL E ZAIFERT
Credential	:	RPH
Telephone Number	:	626-793-7131

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	08/22/2020

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Directions to “MICHAEL'S PHARMACY ” Practice Location

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