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MSM HOLDCO LLC NPI 1366693665


NPI Information

NPI: 1366693665
Provider Name: MSM HOLDCO, LLC

Former Legal Business Name: MARTINS SUPER MARKETS INC

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
314 N IRONWOOD DR
MISHAWAKA, IN
ZIP 46544
Phone: (574) 254-2323
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MSM HOLDCO, LLC is a community/retail pharmacy pharmacy in Mishawaka, IN. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. MSM HOLDCO, LLC NPI is 1366693665. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Martins Super Markets Inc.

The provider's business location address is:

314 N IRONWOOD DR
MISHAWAKA, IN
ZIP 46544-543
Phone: (574) 254-2323
Fax: (574) 254-2320

The provider's authorized official is Amy Ellis .
The authorized official title is Director Of Pharmacy and has the following contact phone number (616) 878-2848.

The enumeration date for this NPI number is 10/6/2008 and was last updated on 1/8/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail Pharmacy60006166AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11562330OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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