South Bend Specialty Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

60006503A Issued in IN

Legal business name

SOUTH BEND SPECIALTY PHARMACY LLC

Practice address

54590 Ironwood Rd
South Bend, IN 46635-1617

Phone

(574) 968-3717

Fax

(574) 314-6916

NPI assigned

Dec 8, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elaine Almeida

Title

Owner

Phone

(574) 968-3717

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• South Bend Specialty Pharmacy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Monica Lynn Parkhurst, BPHARM, R.PH.

  • Pharmacist
  • South Bend, IN
  • NPI 1609151596
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563667200000",
    "number": "1376941344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54590 IRONWOOD RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351617",
            "telephone_number": "574-807-6170",
            "fax_number": "877-235-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54590 IRONWOOD RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351617",
            "telephone_number": "574-968-3717",
            "fax_number": "574-314-6916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BEND SPECIALTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-08",
        "last_updated": "2019-07-21",
        "status": "A",
        "authorized_official_last_name": "ALMEIDA",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-968-3717"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60006503A",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154848",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Bend Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Bend Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chandaly Sovan, PHARM.D.
• Catlyn Love Spake, RBT
• Rachelle Sparks

• Community/Retail Pharmacy in South Bend, IN
• Providers in South Bend, IN by specialty
• Community/Retail Pharmacy in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.