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MSM HOLDCO LLC NPI 1629525738


NPI Information

NPI: 1629525738
Provider Name: MSM HOLDCO, LLC

Doing Business As: MARTIN'S PHARMACY AT SJRMC

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
611 E DOUGLAS RD STE 104
MISHAWAKA, IN
ZIP 46545
Phone: (574) 247-1000
Get Directions

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 1629525738. The provider is registered as an organization entity type.
The provider Is Doing Business As Martin's Pharmacy At Sjrmc.

The provider's business location address is:

611 E DOUGLAS RD STE 104
MISHAWAKA, IN
ZIP 46545-480
Phone: (574) 247-1000
Fax: (574) 208-6020

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 9/7/2016 and was last updated on 12/7/2023.


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 Pharmacy60006269AINDIANAYes

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
12163717OTHERPK

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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