Mixlab Wi, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

MIXLAB WI, LLC

Practice address

407 W Silver Spring Dr
Milwaukee, WI 53217-5048

Phone

(888) 901-4480

Fax

(212) 967-0892

NPI assigned

Nov 26, 2024

Organization subpart

Yes

Parent organization

MIXLAB, INC.As reported in NPPES

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

Authorized official

Name

Vinnie Dam, PHARMD, MS

Title

Chief Pharmacy Officer

Phone

(347) 610-9820

Specialties & licenses 1

Addresses

Part of

Mixlab Inc

Locations

Practitioners 1

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

• Vinh Dam, PHARM.D.

  • Pharmacist
  • Bloomfield, NJ
  • NPI 1255640355
  NPD

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1932925633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 W SILVER SPRING DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532175048",
            "telephone_number": "888-901-4480",
            "fax_number": "212-967-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 W SILVER SPRING DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532175048",
            "telephone_number": "888-901-4480",
            "fax_number": "212-967-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIXLAB WI, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIXLAB, INC.",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "DAM",
        "authorized_official_first_name": "VINNIE",
        "authorized_official_title_or_position": "CHIEF PHARMACY OFFICER",
        "authorized_official_telephone_number": "347-610-9820",
        "authorized_official_credential": "PHARMD, MS"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet L Mittelstadt, MNT
• Paul Everett Mittelstadt, M.D.
• Abrielle Mitten, SAC-IT
• Kathleen Mitten, RN, BSN
• Mixe Transport Service LLC
• Ashleigh Mixon
• Roger C Mixter, M.D.
• David T Miyama, M.D.
• Amanda Taylor Mizia, PA-C
• MJ Care, Inc.

• Pharmacy in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.