Organization
MSM HOLDCO, LLC
Active
Other names
Martin's Pharmacy #2324, Martin's Pharmacy #24, Martin's Super Market, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELLIS RPH (DIRECTOR OF PHARMACY)
(616) 878-2848
Entity
Organization
Contact information
Practice address
1527 BASHOR ROAD, GOSHEN, IN 46528
(574) 533-5600
Mailing address
1527 MOMENTUM PLACE, CHICAGO, IL 60689-5315
(616) 878-8584
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
60005914A
IN
Other
Enumeration date
11/07/2006
Last updated
12/07/2023
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