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Organization
LTC RX INC
Active
Organization
LTC RX INC
Active
Other names
LTC Rx
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL WINGER (OWNER)
(715) 723-9192
Entity
Organization
Contact information
Practice address
13 E SPRUCE ST STE 102, CHIPPEWA FALLS, WI 54729-2579
(715) 861-4422
(715) 861-5141
Mailing address
13 E SPRUCE ST STE 102, CHIPPEWA FALLS, WI 54729-2579
(715) 861-4422
(715) 861-5141
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0004X
Compounding Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
9055-042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100013800
—
WI
01
—
2129386
PK
—
Enumeration date
12/28/2010
Last updated
02/21/2017
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