Liberty Compounding Pharmacy, LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

5301008780 Issued in MI

Legal business name

LIBERTY COMPOUNDING PHARMACY, LLC

Practice address

7355 Lewis Ave
Suite D
Temperance, MI 48182

Phone

(734) 847-8888

Fax

(734) 847-8884

NPI assigned

Jan 14, 2008

Last updated

Jan 14, 2008By 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

Mr. Timothy J Kirk, R.PH.

Title

Owner

Phone

(734) 847-8888

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1144406703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7355 LEWIS AVE",
            "address_2": "SUITE D",
            "city": "TEMPERANCE",
            "state": "MI",
            "postal_code": "48182",
            "telephone_number": "734-847-8888",
            "fax_number": "734-847-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7355 LEWIS AVE",
            "address_2": "SUITE D",
            "city": "TEMPERANCE",
            "state": "MI",
            "postal_code": "48182",
            "telephone_number": "734-847-8888",
            "fax_number": "734-847-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY COMPOUNDING PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-847-8888",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "MI",
            "license": "5301008780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Erie Medical & Surgical Supply, Inc
• Joseph A. Lascala, DC
• Melissa Ann Lemay, RN
• Penelope Lynne Lemay, LPN
• Levan Chiropractic
• Liberty Corners Dental PLLC
• Lifestyle Chiropractic PC
• Laura L Long, RD
• Ruben J Loo, PT
• Ahsen Aftab Malik

• Compounding Pharmacy in Temperance, MI
• Providers in Temperance, MI by specialty
• Compounding Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.