Specialty Medicine Compounding Pharmacy
NPI #1083770978 in South Lyon, Michigan
Provider Information
- NPI Number
- 1083770978
- Entity Type
- Organization
- Organization Name
- Specialty Medicine Compounding Pharmacy
- Primary Specialty
- Pharmacy - Compounding Pharmacy
- Enumeration Date
- Dec 28, 2006
- Last Updated
- Apr 19, 2013
Practice Location
- Address
- 350 S LAFAYETTE ST
- City
- South Lyon
- State
- Michigan
- ZIP Code
- 48178-1814
- Phone
- (248) 446-2643
Authorized Official
- Name
- MR. KENNY RAY WALKUP JR., RPH
- Title
- OWNER
- Phone
- (248) 446-2643
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Compounding Pharmacy — Compounding Pharmacy |
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