Organization
MED CHOICE LTC PHARMACY LLC
Active
Other names
MED CHOICE LTC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRATAP KRISHNA ANNE (PHARMACY OWNER)
(209) 298-1715
Entity
Organization
Contact information
Practice address
2222 E ORANGEBURG AVE STE B3, MODESTO, CA 95355-3472
(209) 298-1715
(559) 369-2408
Mailing address
3838 SHERMAN DR STE 2, RIVERSIDE, CA 92503-4001
(951) 637-3399
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60512
PHARMACY LICENSE
CA
Enumeration date
02/21/2023
Last updated
02/11/2025
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