Mix Pharmacy, LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

265034 Issued in MN

Legal business name

MIX PHARMACY, LLC

Practice address

1266 Helmo Ave N
Oakdale, MN 55128

Phone

(651) 645-9715

Fax

(651) 925-8659

NPI assigned

Feb 15, 2007

Last updated

Jul 5, 2018By 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

Alanna Humphrey

Title

Owner

Phone

(612) 275-8910

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Fischer, PHARMD

  • Pharmacist
  • Willernie, MN
  • NPI 1104534908
  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530748800000",
    "number": "1346383601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1266 HELMO AVE N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "55128",
            "telephone_number": "651-645-9715",
            "fax_number": "651-925-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1266 HELMO AVE N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "55128",
            "telephone_number": "651-645-9715",
            "fax_number": "651-925-8659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIX PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2018-07-05",
        "status": "A",
        "authorized_official_last_name": "HUMPHREY",
        "authorized_official_first_name": "ALANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-275-8910"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "MN",
            "license": "265034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Compounding Pharmacy in Oakdale, MN
• Providers in Oakdale, MN by specialty
• Compounding Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2018; 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.