# LOTUS LTC PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lotus Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629613005
- **Authorized official:** JILL MARIE LYTWYN RPH (CEO)
- **Authorized official phone:** (612) 425-9145

## Contact information

- **Practice address:** 9850 51ST AVE N STE 102, PLYMOUTH, MN 55442-3271
- **Practice address phone:** (612) 415-9145
- **Mailing address:** PO BOX 27559, GOLDEN VALLEY, MN 55427-0559
- **Mailing address phone:** (612) 425-9145

## Taxonomy

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

## Other

- **Enumeration date:** 11/09/2019
- **Last updated:** 04/22/2022