PerforMIX Pharmacy Team


Natalie Cote | Pharmacy Manager/Owner

Natalie Cote, PharmD, has over 12 years of experience with pharmaceutical compounding and customized solutions. Her training started with hands-on experience in a compounding pharmacy and continued through several experiential rotations advanced training through Professional Compounding Centers of America and a specialized certification as a Pain Management Specialist. Natalie also serves as a preceptor to students at local colleges of pharmacy. Natalie is passionate about developing tailored medication therapies and enjoys serving as a clinical resource for practitioners.

At PerforMix Specialty Pharmacy, Natalie continues to deliver optimal compounded medication therapies by pairing thoughtful collaboration with patients and providers with the highest quality compounding standards.

Natalie can be reached via email at or by telephone (603) 870-9618.


James A. Tomacchio Sr. | Director of Pharmacy/Owner

As Director of Pharmacy, Tomacchio holds a Bachelor of Science in Pharmacy from Northeastern University, and has been a dedicated health care professional since 1979. Over the years, Tomacchio has worked in numerous capacities, serving as a nursing home consultant, retail pharmacist, and liaison for managed care and as an on-site pharmacist and compounding specialist for four major hospitals.

At PerforMix Specialty Pharmacy, Tomacchio takes pride in his ability to build meaningful, lasting relationships with both patients and doctors, and working to meet their needs on all levels. His incredible dedication to disease state management and patient advocacy is evident, as he works to provide integrated solutions aimed at improving patient outcomes.

Tomacchio can be reached by email at

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Carley Spinazzola | Lead Compounding Technician

Carley Spinazzola, CPhT, has over 10 years experience in the pharmacy industry. Carley began her path to lead compounding technician by starting at the front desk and building knowledge to eventually be working in the lab. While PerforMIX Pharmacy caters to all specialties, Carley has a passion for compounding vet and pediatric medications, BHRT therapies, capsules, and troches in the highly controlled lab room.

Apart from her work in the lab, Carley enjoys motorsports, watching the Boston Bruins, and outdoor activities.