LTC Leonard LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301000646 Issued in MI

Legal business name

LTC LEONARD LLC

Practice address

4646 Page Avenue
Michigan Center, MI 49254-1042

Phone

(517) 764-0400

Fax

(517) 764-0475

NPI assigned

Feb 3, 2006

Organization subpart

Yes

Parent organization

PRESCRIPTION SUPPLY INCAs reported in NPPES

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

Authorized official

Name

Christopher Schoen

Title

Vice President

Phone

(419) 654-1973

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• LTC Welcome Pharmacy Michigan Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• LTC Leonard LLC

  • Community/Retail Pharmacy
  • Jackson, MI
  • NPI 1174532592

  2769813724

  Same PAC ID

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1922070929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 TRACY RD STE B",
            "city": "NORTHWOOD",
            "state": "OH",
            "postal_code": "436191302",
            "telephone_number": "517-764-0400",
            "fax_number": "517-764-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 PAGE AVENUE",
            "city": "MICHIGAN CENTER",
            "state": "MI",
            "postal_code": "492541042",
            "telephone_number": "517-764-0400",
            "fax_number": "517-764-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTC LEONARD LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESCRIPTION SUPPLY INC",
        "enumeration_date": "2006-02-03",
        "last_updated": "2023-03-07",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "SCHOEN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "419-654-1973"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "5301000646",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301000646",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301000646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP/NABP",
            "identifier": "2307254",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "872503134",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "540C805637",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LTC Welcome Pharmacy Michigan Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LTC Welcome Pharmacy Michigan Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James L Horrigan II, LMSW AND RN
• Anthony Griffeth Hunter, B.S., R.PH.
• Joseph a Mayo Jr DC PC
• Limitless Dental Care Center PLLC
• LTC Leonard LLC
• Hamead Moshrefi
• Erich Okonowski, MS
• Matthew Lee Opanasenko, DPT
• John Gregory Palanci, D.D.S.
• Stacey Marie Payne, RN

• Community/Retail Pharmacy in Michigan Center, MI
• Providers in Michigan Center, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.