Organization · Type 2 NPI

MSM Holdco, LLC

Community/Retail Pharmacy · South Bend, IN

NPI number 1578015103 Active

Practice location

525 S. Mayflower Rd
South Bend, IN 46619

Call (574) 334-5200 Map

Fax (574) 334-5198

Mailing address

1527 Momentum Place
Chicago, IL 60689-5315

Specialties and licenses

Taxonomy	Code	License
Community/Retail Pharmacy Primary	3336C0003X	None listed

Community/Retail Pharmacy: 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 …

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NPI record

NPI: 1578015103
Entity type: Organization (Type 2)
Issued: Oct 31, 2016
Last updated: Jan 8, 2024
Status: Active

Other names

<unavail>
Martin's Pharmacy #2308 · doing business as
Martin's Pharmacy #8 · doing business as
Martin's Super Markets, Inc. · former legal business name

Authorized official

Amy Ellis, RPH
Director of Pharmacy
(616) 878-2848

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1578015103

MSM Holdco, LLC's National Provider Identifier is 1578015103, issued on Oct 31, 2016. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in South Bend, IN. The record was last updated on Jan 8, 2024.