MEDICARE: VENOY RX 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	3336C0003X	Community/Retail Pharmacy	5301009772	MI

General Provider Information

NPI Number	:	1588913370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VENOY RX LLC

Provider Business Mailing Address
First Line	:	4515 S TELEGRAPH RD
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48125-1934
Country	:	US
Telephone Number	:	313-438-6222
Fax Number	:	313-438-0175

Provider Business Practice Location Address
First Line	:	4515 S TELEGRAPH RD
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48125-1934
Country	:	US
Telephone Number	:	313-438-6222
Fax Number	:	313-438-0175

Authorized Official
Title or Position	:	OWNER
Name	:	FATEN ZAKI MACHAIK
Credential	:
Telephone Number	:	313-438-6222

Provider Enumeration Date	:	09/07/2012
Last Update Date	:	05/01/2018

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Directions to “VENOY RX LLC ” Practice Location

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