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General NPI Number Information
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NPI Number | 1174486302
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Entity Type | Organization
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Legal Business Name | VITALMIX RX LLC
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 50 LAKEVILLE RD
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-3052
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Country | US
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Telephone | 516-960-5161
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Fax |
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Provider Business Mailing Address
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Address Line | 50 LAKEVILLE RD
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-3052
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Country | US
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Telephone | 516-960-5161
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | MARK MURDAKHAYEV
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Credential |
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Telephone | 347-414-3236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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