# LIFECARE PHARMACY LTC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588336937
- **Authorized official:** PREM KALIDINDI RPH (OWNER)
- **Authorized official phone:** (210) 881-0890

## Contact information

- **Practice address:** 6609 BLANCO RD STE 312, SAN ANTONIO, TX 78216-6179
- **Practice address phone:** (210) 881-0890
- **Mailing address:** PO BOX 12929, SAN ANTONIO, TX 78212-0929

## Taxonomy

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

## Other

- **Enumeration date:** 10/04/2021
- **Last updated:** 10/04/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 33956 | TEXAS STATE BOARD OF PHARMACY | TX |