# NUTRITIONAL DESIGNS LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** NUTRITIONAL DESIGNS AND PHARMACY LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912019837
- **Authorized official:** JODY MUNIZ (OWNER)
- **Authorized official phone:** (262) 632-6500

## Contact information

- **Practice address:** 5220 WASHINGTON AVE STE 101, RACINE, WI 53406-4228
- **Practice address phone:** (262) 632-6500
- **Practice address fax:** (262) 632-6505
- **Mailing address:** 5220 WASHINGTON AVE, SUITE 101, RACINE, WI 53406-4228
- **Mailing address phone:** (262) 632-6500
- **Mailing address fax:** (262) 632-6505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 9184-42 | WI | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 07/14/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2110287 | PK | — |
| 05 | — | 33281600 | — | WI |