# MED CHOICE LTC PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MED CHOICE LTC PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689372393
- **Authorized official:** MR. PRATAP KRISHNA ANNE (PHARMACY OWNER)
- **Authorized official phone:** (209) 298-1715

## Contact information

- **Practice address:** 2222 E ORANGEBURG AVE STE B3, MODESTO, CA 95355-3472
- **Practice address phone:** (209) 298-1715
- **Practice address fax:** (559) 369-2408
- **Mailing address:** 3838 SHERMAN DR STE 2, RIVERSIDE, CA 92503-4001
- **Mailing address phone:** (951) 637-3399

## Taxonomy

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

## Other

- **Enumeration date:** 02/21/2023
- **Last updated:** 02/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 60512 | PHARMACY LICENSE | CA |