Organization
MSM HOLDCO, LLC
Active
Other names
Martin's Pharmacy #8, Martin's Super Markets, Inc., Martin's Pharmacy #2308
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELLIS RPH (DIRECTOR OF PHARMACY)
(616) 878-2848
Entity
Organization
Contact information
Practice address
525 S. MAYFLOWER RD, SOUTH BEND, IN 46619
(574) 334-5200
(574) 334-5198
Mailing address
1527 MOMENTUM PLACE, CHICAGO, IL 60689-5315
(616) 878-8584
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
IN
Other
Enumeration date
10/31/2016
Last updated
01/08/2024
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