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General NPI Number Information
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NPI Number | 1104136605
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Entity Type | Organization
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Legal Business Name | EZ RX LLC
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 1059 E 9 MILE ROAD
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City | HAZEL PARK
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State | MI
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Zip | 48030-1855
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Country | US
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Telephone | 248-850-7196
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Fax | 248-850-7081
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Provider Business Mailing Address
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Address Line | 1059 E 9 MILE RD
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City | HAZEL PARK
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State | MI
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Zip | 48030-1855
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Country | US
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Telephone | 248-850-7196
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Fax | 248-850-7081
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Authorized Official
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Title or Position | MEMBER-PRESIDENT
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Name | FAHAD CHUDHRY
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Credential |
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Telephone | 248-808-6929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301009991
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License Number State | MI
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