Provider Demographics
NPI:1477198174
Name:METRO RX
Entity type:Organization
Organization Name:METRO RX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ABOUKHODR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-777-7778
Mailing Address - Street 1:3058 METROPOLITAN PARKWAY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310
Mailing Address - Country:US
Mailing Address - Phone:313-777-7778
Mailing Address - Fax:
Practice Address - Street 1:3058 METROPOLITAN PARKWAY
Practice Address - Street 2:SUITE 107
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310
Practice Address - Country:US
Practice Address - Phone:313-777-7778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy