Organization
LTC PRESCRIPTION PROVIDERS INC
Active
Other names
LTC PRESCRIPTION PROVIDERS INC
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP HOMMERDING (OWNER)
(218) 628-9368
Entity
Organization
Contact information
Practice address
220 3RD AVE, PROCTOR, MN 55810-1617
(218) 628-9368
(218) 628-9370
Mailing address
220 3RD AVE, PROCTOR, MN 55810-1617
(218) 628-9368
(218) 628-9370
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962571810
—
MN
01
—
2048066
PK
—
01
—
266588
MINNESOTAPHARMACYLICENSE
MN
Enumeration date
11/07/2006
Last updated
02/24/2026
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