Organization Active NPI

LTC America LLC

  • Long Term Care Pharmacy
  • Sacramento, CA
National Provider Identifier
1861080236
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
LTC AMERICA LLC
Practice address
3403 Watt Ave
Sacramento, CA 95821-3612
Phone
(916) 836-4000
Fax
(916) 836-5000
NPI assigned
Jan 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Authorized official

Name
Mr. Pratap Krishna Anne
Title
Pharmacy Director
Phone
(916) 836-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

3403 Watt Ave
Sacramento, CA 95821-3612

Mailing address

3403 Watt Ave
Sacramento, CA 95821-3612
Phone (916) 836-4000

Other names 1

  • Town Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20210716000853 CA Part B Supplier - Pharmacy 9739581430 Practice locations: Sacramento, CA
O20210818000704 CA Part B Supplier - Mass Immunization (Roster Biller Only) 9739581430 Practice locations: Sacramento, CA
O20220301002704 CA Part B Supplier - Independent Clinical Laboratory 9739581430 Practice locations: Sacramento, CA
O20230508002376 CA Part B Supplier - Pharmacy 3870958226 Practice locations: Sacramento, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2250842Town Pharmacy3403 Watt Ave, Sacramento, CA 95821Certificate of waiverJan 30, 2028

National Provider Directory

National Provider Directory

Locations

3403 Watt Ave
Sacramento, CA 95821
Phone (916) 836-4000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1609459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1861080236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3403 WATT AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958213612",
            "telephone_number": "916-836-4000",
            "fax_number": "916-836-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3403 WATT AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958213612",
            "telephone_number": "916-836-4000",
            "fax_number": "916-836-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTC AMERICA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-01",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A",
        "authorized_official_last_name": "ANNE",
        "authorized_official_first_name": "PRATAP",
        "authorized_official_middle_name": "KRISHNA",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "916-836-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Town Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.