Ez RX LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009991 Issued in MI

Legal business name

EZ RX LLC

Practice address

1059 E 9 Mile Road
Hazel Park, MI 48030-1855

Phone

(248) 850-7196

Fax

(248) 850-7081

NPI assigned

Oct 18, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Fahad Chudhry

Title

Member-President

Phone

(248) 808-6929

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• MEDPARK RX PHARMACY Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Venu Gopal Potluri, R.PH

  • Pharmacist
  • Hazel Park, MI
  • NPI 1033460563
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1104136605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1059 E 9 MILE RD",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480301855",
            "telephone_number": "248-850-7196",
            "fax_number": "248-850-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1059 E 9 MILE ROAD",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480301855",
            "telephone_number": "248-850-7196",
            "fax_number": "248-850-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZ RX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A",
        "authorized_official_last_name": "CHUDHRY",
        "authorized_official_first_name": "FAHAD",
        "authorized_official_title_or_position": "MEMBER-PRESIDENT",
        "authorized_official_telephone_number": "248-808-6929"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009991",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104136605",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDPARK RX PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Emad Nakkash, MD, PC
• Emily Erdman
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• Kathryn Faraj, NP
• Randy Gordon Fillion, NCTMB
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• Edward Fireberg, D.C.

• Community/Retail Pharmacy in Hazel Park, MI
• Providers in Hazel Park, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.