Most Relevant Information
Provider Data
| NPI Number: | 1003499856 |
| Provider Name: | JUSTIN MCMENAMY PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 051302914 |
Most Important Dates
| Enumeration Date: | 04/29/2021 |
| Last Updated: | 04/29/2021 |
Provider Practice Location
1351 N IRONWOOD DR
SOUTH BEND
IN
466153566
Practice Location Phone/Fax
| Phone: | 5742345036 |
| Fax: |
Provider Mailing Location
1351 N IRONWOOD DR
SOUTH BEND
IN
466153566
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |