Martin's Supermarkets of Nappanee LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

60005775A Issued in IN

Legal business name

MARTIN'S SUPERMARKETS OF NAPPANEE LLC

Doing business as

Martin's Pharmacy #20
Martin's Pharmacy #2320

Practice address

242 N Oakland Ave
Nappanee, IN 46550-2319

Phone

(574) 773-7873

NPI assigned

Nov 3, 2006

Last updated

Dec 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amy Ellis, RPH

Title

Director of Pharmacy

Phone

(616) 878-2848

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Martin's Pharmacy #20 Doing business as
• Martin's Pharmacy #2320 Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Larry Alan Fredericks

  • Pharmacist
  • Nappanee, IN
  • NPI 1700473550
  NPD (past)
• Linda Jean Letherman

  • Pharmacist
  • Nappanee, IN
  • NPI 1447847959
  NPD (past)
• Crystal Stickel, PHARMD

  • Pharmacist
  • Nappanee, IN
  • NPI 1013504059
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1689753493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 MOMENTUM PLACE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895315",
            "telephone_number": "616-878-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 N OAKLAND AVE",
            "city": "NAPPANEE",
            "state": "IN",
            "postal_code": "465502319",
            "telephone_number": "574-773-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN'S SUPERMARKETS OF NAPPANEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "616-878-2848",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60005775A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200462120",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Martin's Pharmacy #20",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Martin's Pharmacy #20",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Martin's Pharmacy #2320",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katelyn M King, OTR
• Linda Jean Letherman
• Kimberly A Linton, MSPT
• Marathon Health, LLC (Marathon Health, Nappanee IN)
• Lisa Ann Marrero, FNPC
• Sabrina A McKinney, FNP
• Sara Jane Mead
• Medstat LLC
• Mellinger Health Care Inc (LuAnn Nursing Home)
• Angela V Miller, M.D.

• Community/Retail Pharmacy in Nappanee, IN
• Providers in Nappanee, 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 Dec 7, 2023; 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.