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General NPI Number Information
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NPI Number | 1013394378
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Entity Type | Organization
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Legal Business Name | ONECARE LTC
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 1945 HEIDE DR STE A
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City | TROY
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State | MI
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Zip | 48084-5313
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Country | US
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Telephone | 248-663-2273
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Fax | 248-663-2275
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Provider Business Mailing Address
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Address Line | PO BOX 1239
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City | BIRMINGHAM
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State | MI
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Zip | 48012-1239
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Country | US
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Telephone | 248-663-2273
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Fax | 248-663-2275
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Authorized Official
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Title or Position | PHARMACY DIRECTOR
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Name | PIERRE BOUTROS
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Credential |
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Telephone | 248-361-6868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 5301010707
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License Number State | MI
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