Active NPI
Med Ex Direct, LLC
Doing business as M D Compounding Solutions
- Compounding Pharmacy
- Warren, MI
National Provider Identifier
1093014573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Compounding Pharmacy
- License
- 5301009263
- Legal business name
- MED EX DIRECT, LLC
- Doing business as
- M D Compounding Solutions
- Practice address
- 13201 Stephens Rd
Suite D
Warren, MI 48089-4340 - Phone
- (877) 881-3100
- Fax
- (877) 899-6360
- NPI assigned
- Mar 23, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. John Gallant
- Title
- President
- Phone
- (877) 881-3100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Compounding Pharmacy | 3336C0004X | 5301009263 | MI | Primary |
Addresses
Primary practice location
13201 Stephens Rd
Suite D
Warren, MI 48089-4340
Mailing address
13201 Stephens Rd
Suite D
Warren, MI 48089-4340
Phone (877) 881-3100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5301009263 | Other | MI | STATE PHARMACY LICENSE |
| 5315043773 | Other | MI | STATE PHARMACY CONTROL LICENSE |
Other names 1
- M D Compounding Solutions
National Provider Directory
National Provider Directory- Tax ID family
- LTC Med Ex Direct
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Locations
13201 Stephens Rd
Ste D
Warren, MI 48089
Phone (877) 881-3100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300838400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1093014573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13201 STEPHENS RD",
"address_2": "SUITE D",
"city": "WARREN",
"state": "MI",
"postal_code": "480894340",
"telephone_number": "877-881-3100",
"fax_number": "877-899-6360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13201 STEPHENS RD",
"address_2": "SUITE D",
"city": "WARREN",
"state": "MI",
"postal_code": "480894340",
"telephone_number": "877-881-3100",
"fax_number": "877-899-6360"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MED EX DIRECT, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-03-23",
"last_updated": "2023-03-07",
"status": "A",
"authorized_official_last_name": "GALLANT",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "877-881-3100",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": "MI",
"license": "5301009263",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PHARMACY LICENSE",
"identifier": "5301009263",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PHARMACY CONTROL LICENSE",
"identifier": "5315043773",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "M D Compounding Solutions",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.