# LTC PHARMACY LLC

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

## Provider details

- **NPI number:** 1588963706
- **Authorized official:** MR. CHRISTOPHER MICHAEL SCHOEN (VICE PRESIDENT)
- **Authorized official phone:** (419) 654-1973

## Contact information

- **Practice address:** 1314 LEONARD ST NW, GRAND RAPIDS, MI 49504-2937
- **Practice address phone:** (616) 214-8011
- **Practice address fax:** (616) 554-9581
- **Mailing address:** 2233 TRACY RD STE B, NORTHWOOD, OH 43619-1302
- **Mailing address phone:** (419) 214-3198
- **Mailing address fax:** (616) 554-9581

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 5301009544 | MI | — |
| 3336C0003X | Community/Retail Pharmacy | 5301009544 | MI | — |
| 3336L0003X | Long Term Care Pharmacy | 5301009544 | MI | Yes |

## Other

- **Enumeration date:** 03/28/2011
- **Last updated:** 03/07/2017