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General NPI Number Information
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NPI Number | 1457293557
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Entity Type | Organization
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Legal Business Name | MODA MEDS RX PLLC
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Dates
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Enumeration Date | 04/07/2026
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Last Update Date | 04/09/2026
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Provider Practice Location Address
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Address Line | 5700 E 11 MILE RD STE 2
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City | WARREN
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State | MI
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Zip | 48091-1229
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Country | US
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Telephone | 586-703-2512
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Fax |
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Provider Business Mailing Address
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Address Line | 5700 E 11 MILE RD STE 2
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City | WARREN
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State | MI
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Zip | 48091-1229
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PIC
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Name | ENDRIT GROPCAJ
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Credential | PHARMD
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Telephone | 586-703-2512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 | 3336L0003X
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Taxonomy Name | Long Term Care 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 |
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License Number State |
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