Healthcare Provider Details

I. General information

NPI: 1689519977
Provider Name (Legal Business Name): ACREDO PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22990 KING RD STE B
BROWNSTOWN TWP MI
48183-1025
US

IV. Provider business mailing address

22990 KING RD STE B
BROWNSTOWN TWP MI
48183-1025
US

V. Phone/Fax

Practice location:
  • Phone: 734-820-1234
  • Fax: 734-820-1235
Mailing address:
  • Phone: 734-820-1234
  • Fax: 734-820-1235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SIU HIU WU
Title or Position: OWNER/PHARMACIST
Credential: RPH
Phone: 734-820-1234