Organization
TRUCARE LTC, LLC
Active
Other names
Trucare LTC Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL HOLTZ (DIRECTOR OF PHARMACY)
(269) 998-6772
Entity
Organization
Contact information
Practice address
2671 HUFFMAN BLVD, JACKSONVILLE, FL 32246-4056
(616) 965-7480
Mailing address
6140 28TH ST SE STE 105, GRAND RAPIDS, MI 49546-6938
(616) 965-7480
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
5301010899
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2165805
PK
—
Enumeration date
10/28/2016
Last updated
10/28/2016
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