# LONG TERM CARE RX

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

## Provider details

- **NPI number:** 1285656215
- **Authorized official:** W DAVID SPENCE (PRESIDENT)
- **Authorized official phone:** (979) 849-3001

## Contact information

- **Practice address:** 2301 E MULBERRY ST STE B, ANGLETON, TX 77515-3804
- **Practice address phone:** (979) 849-3001
- **Practice address fax:** (979) 848-0900
- **Mailing address:** 2301 E MULBERRY ST, SUITE B, ANGLETON, TX 77515-3804
- **Mailing address phone:** (979) 849-3001
- **Mailing address fax:** (979) 848-0900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 24288 | TX | Yes |

## Other

- **Enumeration date:** 07/25/2006
- **Last updated:** 12/11/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4539803 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |