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LTC PHARMACY LLC NPI 1538405774


NPI Information

NPI: 1538405774
Provider Name: LTC PHARMACY, LLC
Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
4477 E PARIS AVE SE
KENTWOOD, MI
ZIP 49512
Phone: (616) 214-8011
Get Directions

LTC PHARMACY, LLC is a pharmacy in Kentwood, MI. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. LTC PHARMACY, LLC NPI is 1538405774. The provider is registered as an organization entity type.

The provider's business location address is:

4477 E PARIS AVE SE
KENTWOOD, MI
ZIP 49512-312
Phone: (616) 214-8011
Fax: (616) 554-9581

The provider's authorized official is Christopher Schoen .
The authorized official title is Vice President and has the following contact phone number (616) 214-8011.

The enumeration date for this NPI number is 12/17/2012 and was last updated on 2/17/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacy5301009544MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11588963706MEDICAIDMICHIGAN
26594330001MEDICARE NSCMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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