Organization
MIX PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALANNA HUMPHREY (OWNER)
(612) 275-8910
Entity
Organization
Contact information
Practice address
1266 HELMO AVE N, OAKDALE, MN 55128
(651) 645-9715
(651) 925-8659
Mailing address
1266 HELMO AVE N, OAKDALE, MN 55128
(651) 645-9715
(651) 925-8959
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
265034
MN
Other
Enumeration date
02/15/2007
Last updated
07/05/2018
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