Martin'S Pharmacy #17

LBN: Martin'S Super Markets Of Elkhart East Llc
Martin'S Pharmacy #17 is an health care organization with primary practice located at 3900 E Bristol St , Elkhart IN 46514-4466. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Martin'S Super Markets Of Elkhart East Llc can be contacted via phone (574) 970-0004, or through Ellis, Amy via phone (616) 878-2848.

Contact Information

Primary practice address
3900 E Bristol St Elkhart IN 46514-4466
Phone: (574) 970-0004
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ellis, Amy RPH
Phone: (616) 878-2848

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 60005670A Indiana

Profile Details

NPI number 1366521171
LBN Legal business name Martin'S Super Markets Of Elkhart East Llc
DBA Doing business as Martin'S Pharmacy #17
Authorized official Ellis, Amy RPH
Entity Organization
Organization subpart 1 No
Enumeration date Nov 3rd, 2006
Last updated Dec 7th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366521171 NPPES
Indiana MEDICAID 200376280A

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