NPIMap

Organization Active NPI

Med Ex Direct LLC

  • Long Term Care Pharmacy
  • Warren, MI
National Provider Identifier
1891970265
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
5315034144 Issued in MI
Legal business name
MED EX DIRECT LLC
Practice address
13201 Stephens Rd
Suite C
Warren, MI 48089-4340
Phone
(586) 353-6300
Fax
(877) 899-6360
NPI assigned
Jan 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Authorized official

Name
Mr. John M Gallant
Title
President
Phone
(586) 353-6337

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Compounding Pharmacy 3336C0004X 5315034144 MI
Long Term Care Pharmacy 3336L0003X 5315034144 MI Primary

Addresses

Primary practice location

13201 Stephens Rd
Suite C
Warren, MI 48089-4340

Mailing address

13201 Stephens Rd
Suite C
Warren, MI 48089-4340
Phone (586) 353-6300

Other identifiers 1

IdentifierTypeStateIssuer
2370637OtherNCPDP

Other names 1

  • LTC Med Ex Direct Doing business as

National Provider Directory

National Provider Directory
Tax ID family
LTC Med Ex Direct2 organizations share this tax ID, including this one

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 C
Warren, MI 48089
Phone (586) 353-6300

NPI Registry JSON

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1891970265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13201 STEPHENS RD",
            "address_2": "SUITE C",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480894340",
            "telephone_number": "586-353-6300",
            "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 C",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480894340",
            "telephone_number": "586-353-6300",
            "fax_number": "877-899-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED EX DIRECT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-04",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "GALLANT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-353-6337",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "MI",
            "license": "5315034144",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MI",
            "license": "5315034144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2370637",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LTC Med Ex Direct",
            "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 Jun 11, 2015; 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.