Healthcare Provider Details

I. General information

NPI: 1457293557
Provider Name (Legal Business Name): MODA MEDS RX PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 E 11 MILE RD STE 2
WARREN MI
48091-1229
US

IV. Provider business mailing address

5700 E 11 MILE RD STE 2
WARREN MI
48091-1229
US

V. Phone/Fax

Practice location:
  • Phone: 248-404-5045
  • Fax: 248-404-5126
Mailing address:
  • Phone: 248-404-5045
  • Fax: 248-404-5126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ENDRIT GROPCAJ
Title or Position: PIC
Credential: PHARMD
Phone: 586-703-2512