Healthcare Provider Details

I. General information

NPI: 1922463686
Provider Name (Legal Business Name): FIDMARC EXPRESS PHARMACY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2015
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21737 W 8 MILE RD STE A
DETROIT MI
48219-4430
US

IV. Provider business mailing address

21737 8 MILE RD STE A
DETROIT MI
48219
US

V. Phone/Fax

Practice location:
  • Phone: 313-766-7432
  • Fax: 313-766-7957
Mailing address:
  • Phone: 313-766-7432
  • Fax: 313-766-7957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301010902
License Number StateMI

VIII. Authorized Official

Name: CHINWENDU OKOYE
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 248-345-0862