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

2671 Huffman Blvd
Jacksonville, FL 32246-4056

Phone

(616) 965-7480

NPI assigned

Oct 28, 2016

Last updated

Oct 28, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael HoltzNPI 1679573364

Title

Director of Pharmacy

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
  • Grand Rapids, MI
  • NPI 1114384559
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael A Holtz, R.PH.

  • Pharmacist
  • Shelbyville, MI
  • NPI 1679573364
  Authorized official Same address or phone

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

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477612800000",
    "number": "1114479821",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2671 HUFFMAN BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322464056",
            "telephone_number": "616-965-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUCARE LTC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-28",
        "last_updated": "2016-10-28",
        "status": "A",
        "authorized_official_last_name": "HOLTZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "269-998-6772"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "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": "2165805",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trucare LTC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Rachel Trude, DO
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• Long Term Care Pharmacy in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Long Term Care Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.