Trucare LTC, LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

5301010899 Issued in MI

Legal business name

TRUCARE LTC, LLC

Doing business as

Trucare LTC Pharmacy

Practice address

6140 28TH St SE Ste 105
Grand Rapids, MI 49546-6938

Phone

(616) 965-7480

Fax

(616) 974-8205

NPI assigned

Jan 15, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Holtz

Title

Pharmacy President

Phone

(269) 998-6772

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• TRUCARE LTC PHARMACY Doing business as

Tax ID family

Trucare LTC LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Trucare LTC, LLC

  dba Trucare LTC Pharmacy

  • Long Term Care Pharmacy
  • Jacksonville, FL
  • NPI 1114479821
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467676800000",
    "number": "1114384559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 28TH ST SE STE 105",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466938",
            "telephone_number": "616-965-7480",
            "fax_number": "616-974-8205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 28TH ST SE STE 105",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466938",
            "telephone_number": "616-965-7480",
            "fax_number": "616-974-8205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUCARE LTC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-15",
        "last_updated": "2016-07-05",
        "status": "A",
        "authorized_official_last_name": "HOLTZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PHARMACY PRESIDENT",
        "authorized_official_telephone_number": "269-998-6772"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MI",
            "license": "5301010899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155947",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRUCARE LTC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Long Term Care Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.