Healthcare Provider Details

I. General information

NPI: 1013394378
Provider Name (Legal Business Name): ONECARE LTC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 HEIDE DR STE A
TROY MI
48084-5313
US

IV. Provider business mailing address

PO BOX 1239
BIRMINGHAM MI
48012-1239
US

V. Phone/Fax

Practice location:
  • Phone: 248-663-2273
  • Fax: 248-663-2275
Mailing address:
  • Phone: 248-663-2273
  • Fax: 248-663-2275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number5301010707
License Number StateMI

VIII. Authorized Official

Name: PIERRE BOUTROS
Title or Position: PHARMACY DIRECTOR
Credential:
Phone: 248-361-6868