Organization
MAR-MAIN PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAN M BOPP PHARMD, RPH (PHARMACIST)
(574) 234-3184
Entity
Organization
Contact information
Practice address
426 N MICHIGAN ST, SOUTH BEND, IN 46601-1228
(574) 234-3184
Mailing address
426 N MICHIGAN ST, SOUTH BEND, IN 46601-1228
(574) 234-3184
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
60005199A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1502081
NABP
IN
Enumeration date
07/07/2005
Last updated
08/22/2020
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