Healthcare Provider Details

I. General information

NPI: 1417725086
Provider Name (Legal Business Name): NEXTGEN RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2023
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29866 FORD RD
GARDEN CITY MI
48135-2365
US

IV. Provider business mailing address

29866 FORD RD
GARDEN CITY MI
48135-2365
US

V. Phone/Fax

Practice location:
  • Phone: 734-720-1980
  • Fax: 734-374-2291
Mailing address:
  • Phone: 734-720-1980
  • Fax: 734-374-2291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ANIS SOUEIDAN
Title or Position: OWNER
Credential: PHARM.D., RPH
Phone: 734-720-1980