Mix It RX LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MIX IT RX LLC

Practice address

4775 Lexington Blvd
Missouri City, TX 77459-2801

Phone

(346) 341-7995

Fax

(346) 770-3157

NPI assigned

Jun 8, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Kecia Anderson, PHARMDNPI 1104191857

Title

Pharmacist-in-Charge

Phone

(612) 386-9483

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kecia Devires Anderson, PHARM.D.

  • Pharmacist
  • Pearland, TX
  • NPI 1104191857
  NPD Authorized official

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1316562143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4775 LEXINGTON BLVD",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774592801",
            "telephone_number": "346-341-7995",
            "fax_number": "346-770-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4775 LEXINGTON BLVD",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774592801",
            "telephone_number": "346-341-7995",
            "fax_number": "346-770-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIX IT RX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "KECIA",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "612-386-9483",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "691069",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mixed Blessings, LLC. (Master's Touch Home Health)
• MNL Medical Supplies, LLC
• Mo City Apothecary LLC
• Mo City Chiropractic and Wellness Clinic LLC
• Nassrin Nowroozi Mobasheri, D.C.

• Community/Retail Pharmacy in Missouri City, TX
• Providers in Missouri City, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.