Healthcare Provider Details

I. General information

NPI: 1336644046
Provider Name (Legal Business Name): GARDEN CITY PHARMACY & GROCERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2018
Last Update Date: 05/17/2025
Certification Date: 05/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37672 FORD RD
WESTLAND MI
48185-1924
US

IV. Provider business mailing address

37672 FORD RD
WESTLAND MI
48185-1924
US

V. Phone/Fax

Practice location:
  • Phone: 734-666-1588
  • Fax: 734-469-2606
Mailing address:
  • Phone: 734-666-1588
  • Fax: 734-469-2606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number5301011333
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CALLISTUS MORGAN ONWENU
Title or Position: OWNER
Credential:
Phone: 734-666-1588