Organization
ARCHANGEL MICHAEL LLC
Active
Other names
White Flint Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAEN SIDHOM RPH (RX MANAGER)
(301) 321-2525
Entity
Organization
Contact information
Practice address
11125 ROCKVILLE PIKE STE 102, ROCKVILLE, MD 20852-3142
(301) 321-2525
(301) 321-2626
Mailing address
11125 ROCKVILLE PIKE STE 102, ROCKVILLE, MD 20852-3142
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326756057
—
VA
05
—
209675700
—
MD
Enumeration date
11/10/2022
Last updated
06/18/2025
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