Creative Compounding Center, Inc.

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

L222954 Issued in MI

Legal business name

CREATIVE COMPOUNDING CENTER, INC.

Practice address

631 N Van Dyke Rd
Imlay City, MI 48444-1181

Phone

(810) 724-3301

Fax

(810) 724-3303

NPI assigned

Sep 9, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Cheryl Lynn Dufresne

Title

President

Phone

(810) 724-3301

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441756800000",
    "number": "1073981957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 N VAN DYKE RD",
            "city": "IMLAY CITY",
            "state": "MI",
            "postal_code": "484441181",
            "telephone_number": "810-724-3301",
            "fax_number": "810-724-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 N VAN DYKE RD",
            "city": "IMLAY CITY",
            "state": "MI",
            "postal_code": "484441181",
            "telephone_number": "810-724-3301",
            "fax_number": "810-724-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE COMPOUNDING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A",
        "authorized_official_last_name": "DUFRESNE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-724-3301",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "MI",
            "license": "L222954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Compounding Pharmacy in Imlay City, MI
• Providers in Imlay City, MI by specialty
• Compounding Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.