Organization
UNIVERSITY COMPOUNDING CENTER LLC
Active
Other names
Univerisity Compounding Center
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW REEVES (CO-OWNER)
(269) 337-6368
Entity
Organization
Contact information
Practice address
1429 W SAGINAW ST STE 140, EAST LANSING, MI 48823-3989
(517) 351-6337
Mailing address
1429 W SAGINAW ST, SUITE 140, EAST LANSING, MI 48823-3989
(517) 351-6337
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
5301008641
MI
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2373885
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/10/2007
Last updated
06/22/2010
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