Organization
MISHAWAKA MEDICAL ARTS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALVIN E JONES RPH CEO (PHARMACIST OWNER)
(574) 255-3331
Entity
Organization
Contact information
Practice address
303 S MAIN ST, MISHAWAKA, IN 46544-2189
(574) 255-3331
(574) 255-3331
Mailing address
303 S MAIN ST, MISHAWAKA, IN 46544-2189
(574) 255-3331
(574) 255-3331
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
26091645A
IN
183500000X
Pharmacist
Primary
60002411A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100301070A
—
IN
Enumeration date
08/10/2006
Last updated
04/08/2014
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