# MLM PHARMACY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MEDICINE SHOPPE PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285728691
- **Authorized official:** MICHAEL MORTON (OWNER)
- **Authorized official phone:** (618) 548-0070

## Contact information

- **Practice address:** 215 N BROADWAY AVE, SALEM, IL 62881-1511
- **Practice address phone:** (618) 548-0070
- **Practice address fax:** (618) 548-9846
- **Mailing address:** 215 N BROADWAY AVE, SALEM, IL 62881-1511

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | IL | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | IL | — |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | IL | — |
| 3336C0003X | Community/Retail Pharmacy | 054014788 | IL | Yes |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 03/07/2023