Organization
SOUTH BEND SPECIALTY PHARMACY LLC
Active
Other names
South Bend Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE ALMEIDA (OWNER)
(574) 968-3717
Entity
Organization
Contact information
Practice address
54590 IRONWOOD RD, SOUTH BEND, IN 46635-1617
(574) 968-3717
(574) 314-6916
Mailing address
54590 IRONWOOD RD, SOUTH BEND, IN 46635-1617
(574) 807-6170
(877) 235-7012
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60006503A
IN
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154848
PK
—
Enumeration date
12/08/2014
Last updated
07/21/2019
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