Provider Demographics
NPI:1245666361
Name:RIVER ROUGE PHARMACY INC
Entity type:Organization
Organization Name:RIVER ROUGE PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELZAGHIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-438-6825
Mailing Address - Street 1:10550 W JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER ROUGE
Mailing Address - State:MI
Mailing Address - Zip Code:48218-1307
Mailing Address - Country:US
Mailing Address - Phone:313-438-6825
Mailing Address - Fax:313-438-6830
Practice Address - Street 1:10550 W JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:RIVER ROUGE
Practice Address - State:MI
Practice Address - Zip Code:48218-1307
Practice Address - Country:US
Practice Address - Phone:313-438-6825
Practice Address - Fax:313-438-6830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-20
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy