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Organization
NOODLES, INC
Active
Organization
NOODLES, INC
Active
Parent organization
NOODLES, INC., DBA MIKE'S COMPOUNDING APOTHECARY
Other names
MIKE'S COMPOUNDING APOTHECARY
Organization subpart
Yes
Provider details
NPI number
Legal business name
NOODLES, INC., DBA MIKE'S COMPOUNDING APOTHECARY
Authorized official
MICHAEL P GRAEFF RPH (PHARMACIST)
(971) 601-0551
Entity
Organization
Contact information
Practice address
95 S COTTAGE AVE, GEARHART, OR 97138-4051
(971) 601-0551
Mailing address
95 S COTTAGE AVE, GEARHART, OR 97138-4051
(971) 601-0551
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
—
—
3336C0004X
Compounding Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
06/28/2023
Last updated
06/28/2023
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