Mixlab, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

MIXLAB, INC.

Practice address

3880 N 28TH Ter
Hollywood, FL 33020-1118

Phone

(888) 901-4480

Fax

(212) 267-0892

NPI assigned

Jun 30, 2023

Last updated

Sep 6, 2023By 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

Vinnie Dam

Title

Chief Pharmacy Officer

Phone

(888) 901-4480

Specialties & licenses 3

Addresses

Tax ID family

Mixlab Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Mixlab, Inc.

  • Pharmacy
  • New York, NY
  • NPI 1407365679
  NPD tax ID
• Mixlab, Inc.

  • Pharmacy
  • Los Angeles, CA
  • NPI 1649807140
  NPD tax ID

Locations

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1366129322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 N 28TH TER",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330201118",
            "telephone_number": "888-901-4480",
            "fax_number": "212-267-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 N 28TH TER",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330201118",
            "telephone_number": "888-901-4480",
            "fax_number": "212-267-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIXLAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-09-06",
        "certification_date": "2021-10-14",
        "status": "A",
        "authorized_official_last_name": "DAM",
        "authorized_official_first_name": "VINNIE",
        "authorized_official_title_or_position": "CHIEF PHARMACY OFFICER",
        "authorized_official_telephone_number": "888-901-4480"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• MKB Psychology PA

• Pharmacy in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.