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General NPI Number Information
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NPI Number | 1922463686
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Entity Type | Organization
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Legal Business Name | FIDMARC EXPRESS PHARMACY PLLC
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Dates
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Enumeration Date | 12/23/2015
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 21737 W 8 MILE RD STE A
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City | DETROIT
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State | MI
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Zip | 48219-4430
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Country | US
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Telephone | 313-766-7432
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Fax | 313-766-7957
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Provider Business Mailing Address
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Address Line | 21737 8 MILE RD STE A
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City | DETROIT
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State | MI
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Zip | 48219
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Country | US
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Telephone | 313-766-7432
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Fax | 313-766-7957
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Authorized Official
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Title or Position | PHARMACIST
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Name | CHINWENDU OKOYE
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Credential | PHARMD
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Telephone | 248-345-0862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301010902
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License Number State | MI
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