Organization
MIXLAB, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINH DAM PHARMD, MS (CHIEF PHARMACY OFFICER)
(347) 610-9820
Entity
Organization
Contact information
Practice address
2223 FEDERAL AVE, LOS ANGELES, CA 90064-1403
(888) 901-4480
(212) 967-0892
Mailing address
2223 FEDERAL AVE, LOS ANGELES, CA 90064-1403
(888) 901-4480
(212) 967-0892
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
03/25/2020
Last updated
03/25/2020
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