Healthcare Provider Details

I. General information

NPI: 1568527992
Provider Name (Legal Business Name): THERA SCRIPT PHARMACY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9740 CONANT ST SUITE 3
HAMTRAMCK MI
48212-3307
US

IV. Provider business mailing address

9740 CONANT ST SUITE 3
HAMTRAMCK MI
48212-3307
US

V. Phone/Fax

Practice location:
  • Phone: 313-875-7979
  • Fax: 313-875-4620
Mailing address:
  • Phone: 313-875-7979
  • Fax: 313-875-4620

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 Number5301008559
License Number StateMI

VIII. Authorized Official

Name: MOHAMMED UDDIN
Title or Position: MEMBER
Credential: PHARMD
Phone: 313-875-7979