MEDICARE: ABBY MICHELLE MACKIE PHARMD

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	59880	CA
2	183500000X	Pharmacist	1-13716	KS

General Provider Information

NPI Number	:	1912208224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBY MICHELLE MACKIE PHARMD

Provider Business Mailing Address
First Line	:	19845 COLLINS RD
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91351-4837
Country	:	US
Telephone Number	:	661-250-8547
Fax Number	:

Provider Business Practice Location Address
First Line	:	25050 PEACHLAND AVE STE 100
Second Line	:
City	:	NEWHALL
State	:	CA
Zip	:	91321-5764
Country	:	US
Telephone Number	:	661-255-7910
Fax Number	:	661-255-7987

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2010
Last Update Date	:	04/04/2016

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