Organization
LTC PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER MICHAEL SCHOEN (VICE PRESIDENT)
(419) 654-1973
Entity
Organization
Contact information
Practice address
1314 LEONARD ST NW, GRAND RAPIDS, MI 49504-2937
(616) 214-8011
(616) 554-9581
Mailing address
2233 TRACY RD STE B, NORTHWOOD, OH 43619-1302
(419) 214-3198
(616) 554-9581
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5301009544
MI
3336C0003X
Community/Retail Pharmacy
5301009544
MI
3336L0003X
Long Term Care Pharmacy
Primary
5301009544
MI
Other
Enumeration date
03/28/2011
Last updated
03/07/2017
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