Healthcare Provider Details

I. General information

NPI: 1003723743
Provider Name (Legal Business Name): ELIXIRX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3902 MONROE ST
DEARBORN HEIGHTS MI
48125-2545
US

IV. Provider business mailing address

3902 MONROE ST
DEARBORN HEIGHTS MI
48125-2545
US

V. Phone/Fax

Practice location:
  • Phone: 313-385-5585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: RAMSEY ABDULLA
Title or Position: OWNER
Credential:
Phone: 313-385-5585