Mix Compounding, LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

Y005618 Issued in AZ

Legal business name

MIX COMPOUNDING, LLC

Doing business as

Mix Compounding

Practice address

7110 E McDonald Dr
Suite C-1
Scottsdale, AZ 85253-5426

Phone

(888) 229-3775

Fax

(602) 749-6610

NPI assigned

Jun 27, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Courtney Forster

Title

Owner

Phone

(888) 229-3775

Specialties & licenses 1

Addresses

Other names 1

• Mix Compounding Doing business as

Locations

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372291200000",
    "number": "1568802254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7110 E MCDONALD DR",
            "address_2": "SUITE C-1",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852535426",
            "telephone_number": "888-229-3775",
            "fax_number": "602-749-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 E MCDONALD DR",
            "address_2": "SUITE C-1",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852535426",
            "telephone_number": "888-229-3775",
            "fax_number": "602-749-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIX COMPOUNDING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-27",
        "last_updated": "2013-06-27",
        "status": "A",
        "authorized_official_last_name": "FORSTER",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-229-3775",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "AZ",
            "license": "Y005618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mix Compounding",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jelena Mitrovic
• Arie Boyer Mittman, N.M.D
• Paul Allen Mittman, N.D.
• Anne Mercita Mitzak, CRNA
• Duane L. Mitzel, MD
• Derek Mix, RBT
• Kimberlyn Mizera-Lieske, ND
• MJC Dental, PLLC
• MJW Medical Solutions, PLLC
• ML Haynie DMD PC

• Compounding Pharmacy in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Compounding Pharmacy in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; 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.