University Compounding Center LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

5301008641 Issued in MI

Legal business name

UNIVERSITY COMPOUNDING CENTER LLC

Doing business as

Univerisity Compounding Center

Practice address

1429 W Saginaw St Ste 140
East Lansing, MI 48823-3989

Phone

(517) 351-6337

NPI assigned

Sep 10, 2007

Last updated

Jun 22, 2010By 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

Andrew Reeves

Title

Co-Owner

Phone

(269) 337-6368

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Univerisity Compounding Center Doing business as

Locations

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277164800000",
    "number": "1700071198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1429 W SAGINAW ST",
            "address_2": "SUITE 140",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488233989",
            "telephone_number": "517-351-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1429 W SAGINAW ST STE 140",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488233989",
            "telephone_number": "517-351-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY COMPOUNDING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-10",
        "last_updated": "2010-06-22",
        "status": "A",
        "authorized_official_last_name": "REEVES",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "269-337-6368"
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "MI",
            "license": "5301008641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2373885",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Univerisity Compounding Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zhigniew Jerry Tyskiewicz, MSW LSW
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• Lauren Ulrich
• Kristen Leigh Umphlett, AU.D.
• Sophia Updyke
• Upper Great Lakes Family Health Center (UGL MSU Tele-Psychiatry)
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• Uwh of Michigan PLC
• Matthew C Valassis, DMD

• Compounding Pharmacy in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Compounding Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; 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.