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Organization
MED EX DIRECT, LLC
Active
Organization
MED EX DIRECT, LLC
Active
Other names
M D Compounding Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN GALLANT (PRESIDENT)
(877) 881-3100
Entity
Organization
Contact information
Practice address
13201 STEPHENS RD, SUITE D, WARREN, MI 48089-4340
(877) 881-3100
(877) 899-6360
Mailing address
13201 STEPHENS RD, SUITE D, WARREN, MI 48089-4340
(877) 881-3100
(877) 899-6360
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
5301009263
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5301009263
STATE PHARMACY LICENSE
MI
01
—
5315043773
STATE PHARMACY CONTROL LICENSE
MI
Enumeration date
03/23/2011
Last updated
03/07/2023
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