Provider Demographics
NPI:1164177689
Name:MICHAL, SARAH (RPH, PHARMD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MICHAL
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7555 W BROADWAY AVE STE C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55428-4559
Mailing Address - Country:US
Mailing Address - Phone:763-424-0525
Mailing Address - Fax:763-424-3169
Practice Address - Street 1:7555 W BROADWAY AVE STE C
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55428-4559
Practice Address - Country:US
Practice Address - Phone:763-424-0525
Practice Address - Fax:763-424-3169
Is Sole Proprietor?:No
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN125273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist