Organization
MICHELLE MINE NA
Active
Organization
MICHELLE MINE NA
Active
Other names
Siloam Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE MINE NA (PHARMACIST & OWNER)
(213) 382-0700
Entity
Organization
Contact information
Practice address
2528 W OLYMPIC BLVD, SUITE 102, LOS ANGELES, CA 90006-2922
(213) 382-0700
(213) 480-1442
Mailing address
2528 W OLYMPIC BLVD, SUITE 102, LOS ANGELES, CA 90006-2922
(213) 382-0700
(213) 480-1442
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY43105
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0571667
NCPDP
CA
05
—
PHA431050
—
CA
Enumeration date
01/23/2007
Last updated
12/16/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up