Walled Lake Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

WALLED LAKE PHARMACY LLC

Practice address

1336 S Commerce Rd
Walled Lake, MI 48390-3010

Phone

(248) 574-5552

NPI assigned

Oct 7, 2026

Last updated

Oct 7, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Abdullah Mussad

Title

GM

Phone

(248) 574-5552

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1791331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791331200000",
    "number": "1083518500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 S COMMERCE RD",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 S COMMERCE RD",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903010",
            "telephone_number": "248-574-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLED LAKE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-07",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A",
        "authorized_official_last_name": "MUSSAD",
        "authorized_official_first_name": "ABDULLAH",
        "authorized_official_title_or_position": "GM",
        "authorized_official_telephone_number": "248-574-5552"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.