LIBERTY COMPOUNDING PHARMACY, LLC

Compounding Pharmacy

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.

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Contact Information

LIBERTY COMPOUNDING PHARMACY, LLC

7355 LEWIS AVE
SUITE D
TEMPERANCE, MI 48182

Phone: 734-847-8888
Fax: 734-847-8884
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Compounding Pharmacy	3336C0004X	58	Medical Supply Company with Pharmacist

Indicates primary specialty

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NPI Profile & details for LIBERTY COMPOUNDING PHARMACY, LLC

NPI # 1144406703

LBN Legal business name LIBERTY COMPOUNDING PHARMACY, LLC

Authorized official TIMOTHY KIRK - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/14/2008

Last updated 01/14/2008 - About 18 years ago

Identifiers

License #

5301008780

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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