Healthcare Provider Details

I. General information

NPI: 1740836006
Provider Name (Legal Business Name): LTC SPECIALTY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2019
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

536 HIGHWAY 171 BYPASS
MANY LA
71449
US

IV. Provider business mailing address

PO BOX 1507
MANY LA
71449-1507
US

V. Phone/Fax

Practice location:
  • Phone: 318-273-2650
  • Fax: 318-273-2659
Mailing address:
  • Phone: 318-273-2650
  • Fax: 318-273-2659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LESLIE CURTIS
Title or Position: PIC
Credential: PHARM. D.
Phone: 318-273-2650