# TRUCARE LTC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TRUCARE LTC PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114384559
- **Authorized official:** MICHAEL HOLTZ (PHARMACY PRESIDENT)
- **Authorized official phone:** (269) 998-6772

## Contact information

- **Practice address:** 6140 28TH ST SE STE 105, GRAND RAPIDS, MI 49546-6938
- **Practice address phone:** (616) 965-7480
- **Practice address fax:** (616) 974-8205
- **Mailing address:** 6140 28TH ST SE STE 105, GRAND RAPIDS, MI 49546-6938
- **Mailing address phone:** (616) 965-7480
- **Mailing address fax:** (616) 974-8205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 5301010899 | MI | Yes |

## Other

- **Enumeration date:** 01/15/2016
- **Last updated:** 07/05/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2155947 | PK | — |