Organization
MSM HOLDCO, LLC
Active
Organization
MSM HOLDCO, LLC
Active
Other names
Martins Super Markets Inc, Martin's Pharmacy #2304, Martins Pharmacy #4
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELLIS RPH (DIRECTOR OF PHARMACY)
(616) 878-2848
Entity
Organization
Contact information
Practice address
314 N IRONWOOD DR, MISHAWAKA, IN 46544-1543
(574) 254-2323
(574) 254-2320
Mailing address
1527 MOMENTUM PLACE, CHICAGO, IL 60689-5315
(616) 878-8584
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
60006166A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1562330
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/06/2008
Last updated
01/08/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up