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General NPI Number Information
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NPI Number | 1174532592
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Entity Type | Organization
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Legal Business Name | LTC LEONARD LLC
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 04/22/2020
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Provider Practice Location Address
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Address Line | 303 W PROSPECT ST
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City | JACKSON
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State | MI
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Zip | 49203-4113
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Country | US
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Telephone | 517-787-2132
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Fax | 517-787-0316
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Provider Business Mailing Address
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Address Line | 2233 TRACY RD STE B
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City | NORTHWOOD
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State | OH
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Zip | 43619-1302
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Country | US
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Telephone | 517-787-2132
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Fax | 517-787-0316
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | CHRISTOPHER M SCHOEN
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Credential |
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Telephone | 419-654-1973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 5301001041
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301001041
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License Number State | MI
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