Mix Pharmacy Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

MIX PHARMACY INC

Practice address

6345 Balboa Blvd Ste 211
Encino, CA 91316-1517

Phone

(818) 798-3833

Fax

(818) 302-2500

NPI assigned

Apr 7, 2021

Organization subpart

No

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

Authorized official

Name

Akop Martikyan

Title

Ceo/Sec/Cfo/Dir/President

Phone

(818) 798-3833

Specialties & licenses 1

Addresses

Other names 1

• MIX PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617753600000",
    "number": "1265011027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6345 BALBOA BLVD STE 211",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913161517",
            "telephone_number": "818-798-3833",
            "fax_number": "818-302-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6345 BALBOA BLVD STE 211",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913161517",
            "telephone_number": "818-798-3833",
            "fax_number": "818-302-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIX PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A",
        "authorized_official_last_name": "MARTIKYAN",
        "authorized_official_first_name": "AKOP",
        "authorized_official_title_or_position": "CEO/SEC/CFO/DIR/PRESIDENT",
        "authorized_official_telephone_number": "818-798-3833"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIX PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Encino, CA
• Providers in Encino, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.