Healthcare Provider Details

I. General information

NPI: 1114929874
Provider Name (Legal Business Name): OCEAN PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25416 GODDARD RD
TAYLOR MI
48180-6200
US

IV. Provider business mailing address

25416 GODDARD RD
TAYLOR MI
48180-6200
US

V. Phone/Fax

Practice location:
  • Phone: 313-291-1100
  • Fax: 313-291-1308
Mailing address:
  • Phone: 313-291-1100
  • Fax: 313-291-1308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302023943
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301006897
License Number StateMI

VIII. Authorized Official

Name: MR. CARL F DEMPICH
Title or Position: PRESIDENT
Credential: PHARMACIST
Phone: 313-291-1100