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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

REVIVA COMPOUNDING PHARMACY LLC
NPI 1487566279
Pharmacy - Compounding Pharmacy in Lincoln Park, MI

Active since September 18, 2026
1664 FORT ST, LINCOLN PARK, MI 48146(313) 384-0484 Get Directions Write a Review

NPPES record added: September 18, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Reviva Compounding Pharmacy Llc NPPES

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

REVIVA COMPOUNDING PHARMACY LLC (NPI 1487566279) is a healthcare organization registered as a compounding pharmacy in Lincoln Park, Michigan and active in the NPI registry since September 2026. The organization lists Mary Beydoun, Owner/pharmacist In Charge, as its authorized official.

NPPES Registry Identity

NPI1487566279
Entity TypeOrganization
Primary Taxonomy3336C0004X
Legal Business NameREVIVA COMPOUNDING PHARMACY LLC
Location Address1664 FORT STLincoln Park, MI 48146-1909
Mailing Address1664 Fort StLincoln Park, MI 48146-1909 · (313) 384-0484
Phone(313) 384-0484
Organization SubpartNo
Authorized OfficialMary BeydounOwner/pharmacist In Charge · (313) 701-2261
Enumeration DateSeptember 18, 2026
NPPES CertifiedSeptember 17, 2026
✔ NPI 1487566279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Compounding PharmacySuppliers
Taxonomy Code3336C0004X
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.
1664 FORT ST, Lincoln Park, MI 48146
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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 Reviva Compounding Pharmacy LLC's NPI number?

The NPI number for Reviva Compounding Pharmacy LLC is 1487566279. It was assigned to this organization in the NPPES registry on September 18, 2026.

Where is Reviva Compounding Pharmacy LLC located?

Reviva Compounding Pharmacy LLC is located at 1664 Fort St, Lincoln Park, MI 48146. The listed phone number is (313) 384-0484.

What is Reviva Compounding Pharmacy LLC'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 Reviva Compounding Pharmacy LLC was last updated on September 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.