MEDICARE: MEDICO PHARMACY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1386356368
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICO PHARMACY LLC

Provider Business Mailing Address
First Line	:	16234 GRAND RIVER AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48227-1824
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16234 GRAND RIVER AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48227-1824
Country	:	US
Telephone Number	:	586-329-1166
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	ALEX OUZA
Credential	:
Telephone Number	:	313-587-0212

Provider Enumeration Date	:	12/21/2022
Last Update Date	:	03/24/2026

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Directions to “MEDICO PHARMACY LLC ” Practice Location

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