Organization
LTC LEONARD LLC
Active
Parent organization
PRESCRIPTION SUPPLY INC
Other names
LTC Welcome Pharmacy Michigan Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRESCRIPTION SUPPLY INC
Authorized official
CHRISTOPHER SCHOEN (VICE PRESIDENT)
(419) 654-1973
Entity
Organization
Contact information
Practice address
4646 PAGE AVENUE, MICHIGAN CENTER, MI 49254-1042
(517) 764-0400
(517) 764-0475
Mailing address
2233 TRACY RD STE B, NORTHWOOD, OH 43619-1302
(517) 764-0400
(517) 764-0475
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
5301000646
MI
333600000X
Pharmacy
5301000646
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301000646
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2307254
NCPDP/NABP
MI
01
—
540C805637
BLUE CROSS BLUE SHIELD
MI
05
—
872503134
—
MI
Enumeration date
02/03/2006
Last updated
03/07/2023
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