Provider Demographics
NPI:1326756057
Name:ARCHANGEL MICHAEL LLC
Entity Type:Organization
Organization Name:ARCHANGEL MICHAEL LLC
Other - Org Name:WHITE FLINT FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:STAFF PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRGIS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:301-321-2525
Mailing Address - Street 1:11125 ROCKVILLE PIKE STE 102
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3142
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11125 ROCKVILLE PIKE STE 102
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3142
Practice Address - Country:US
Practice Address - Phone:301-321-2525
Practice Address - Fax:301-321-2626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-10
Last Update Date:2023-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy