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General NPI Number Information
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NPI Number | 1861080236
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Entity Type | Organization
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Legal Business Name | LTC AMERICA LLC
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Dates
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Enumeration Date | 01/01/2021
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 3403 WATT AVE
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City | SACRAMENTO
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State | CA
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Zip | 95821-3612
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Country | US
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Telephone | 916-836-4000
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Fax | 916-836-5000
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Provider Business Mailing Address
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Address Line | 3403 WATT AVE
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City | SACRAMENTO
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State | CA
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Zip | 95821-3612
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Country | US
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Telephone | 916-836-4000
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Fax | 916-836-5000
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Authorized Official
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Title or Position | PHARMACY DIRECTOR
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Name | MR. PRATAP KRISHNA ANNE
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Credential |
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Telephone | 916-836-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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