Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Reviva Compounding Pharmacy LLC

Organization Compounding Pharmacy · NPI 1487566279

Reviva Compounding Pharmacy LLC is a Compounding Pharmacy in Lincoln Park, Michigan. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1664 Fort St
Lincoln Park, MI 48146-1909
Phone: (313) 384-0484
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Compounding Pharmacy (primary) Taxonomy 3336C0004X

Record details

NPI number1487566279
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Beydoun — Owner/Pharmacist In Charge · (313) 701-2261
NPI enumeratedSeptember 18, 2026
Last updated in NPPESSeptember 18, 2026
Certification dateSeptember 17, 2026
Mailing address1664 Fort St, Lincoln Park, MI 48146-1909