Organization
MODERN MEDICAL PHARMACY INC
Active
Organization
MODERN MEDICAL PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES GRIMAUDO (OWNER)
(586) 772-4800
Entity
Organization
Contact information
Practice address
20937 KELLY RD, EASTPOINTE, MI 48021-3128
(586) 772-4800
(586) 772-4870
Mailing address
20937 KELLY RD, EASTPOINTE, MI 48021-3128
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5301002419
MI
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0217470001
—
MI
01
—
2311431
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/31/2006
Last updated
09/11/2025
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