SPECIALTY MEDICINE COMPOUNDING PHARMACY
NPI 1083770978
Pharmacy - Compounding Pharmacy in South Lyon, MI

Active since December 28, 2006
350 S LAFAYETTE ST, SOUTH LYON, MI 48178(248) 446-2643(248) 486-1906 Get Directions Write a Review

NPPES record last updated: April 19, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Specialty Medicine Compounding Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPECIALTY MEDICINE COMPOUNDING PHARMACY (NPI 1083770978) is a healthcare organization registered as a compounding pharmacy in South Lyon, Michigan and active in the NPI registry since December 2006. The organization lists Kenny Ray Walkup, Owner, as its authorized official.

NPPES Registry Identity

NPI1083770978
Entity TypeOrganization
Primary Taxonomy3336C0004X
Legal Business NameSPECIALTY MEDICINE COMPOUNDING PHARMACY
Location Address350 S LAFAYETTE STSouth Lyon, MI 48178-1814
Mailing Address350 S Lafayette StSouth Lyon, MI 48178-1814 · (248) 446-2643 · Fax (248) 486-1906
Fax(248) 486-1906
Organization SubpartNo
Authorized OfficialKenny Ray WalkupOwner · (248) 446-2643
Enumeration DateDecember 28, 2006
Last NPPES UpdateApril 19, 2013
NPI 1083770978 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacy · Compounding PharmacySuppliers
Taxonomy Code3336C0004X
License Licensed in MI · 5301007610
Definition

A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.

350 S LAFAYETTE ST, South Lyon, MI 48178

Other Identifiers 1

Medicare ID-Type Unspecified0N83670

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
350 S LAFAYETTE ST
SOUTH LYON, MI 48178

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Specialty Medicine Compounding Pharmacy's NPI number?

The NPI number for Specialty Medicine Compounding Pharmacy is 1083770978. It was assigned to this organization in the NPPES registry on December 28, 2006.

Where is Specialty Medicine Compounding Pharmacy located?

Specialty Medicine Compounding Pharmacy is located at 350 S Lafayette St, South Lyon, MI 48178. The listed phone number is (248) 446-2643.

What is Specialty Medicine Compounding Pharmacy's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Compounding Pharmacy, with taxonomy code 3336C0004X.

When was this NPI record last updated?

The NPPES record for Specialty Medicine Compounding Pharmacy was last updated on April 19, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.