Organization
MIXPILL COMPOUNDING PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA MAXAM PHARMD (CO-OWNER/PHARMACIST)
(513) 218-4891
Entity
Organization
Contact information
Practice address
245 N MAIN ST STE 400, SPRINGBORO, OH 45066-9172
(937) 806-3102
(937) 550-4415
Mailing address
3139 HIGHLANDS TRL, LEBANON, OH 45036-9446
(513) 218-4891
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
03/14/2022
Last updated
04/14/2022
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