MEDICARE: MERCURY COMPOUNDINGLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	3336C0004X	Compounding Pharmacy
2	3336S0011X	Specialty Pharmacy
3	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1235089020
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCURY COMPOUNDINGLLC

Provider Business Mailing Address
First Line	:	4900 MERCURY DR STE B
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48126-2947
Country	:	US
Telephone Number	:	313-436-0250
Fax Number	:	313-436-0247

Provider Business Practice Location Address
First Line	:	4900 MERCURY DR STE B
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48126-2947
Country	:	US
Telephone Number	:	313-436-0250
Fax Number	:	313-436-0247

Authorized Official
Title or Position	:	OWNER
Name	:	ALI MOUKDAD
Credential	:	PHARMD
Telephone Number	:	313-436-0250

Provider Enumeration Date	:	01/30/2026
Last Update Date	:	02/03/2026

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Directions to “MERCURY COMPOUNDINGLLC ” Practice Location

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