Organization
ARCHANGEL MICHAEL LLC
Active
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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