LTC LEONARD LLC (NPI# 1922070929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922070929 |
| Entity Type | Organization |
| Organization Name | LTC LEONARD LLC |
| Other Organization Name | LTC WELCOME PHARMACY MICHIGAN CENTER |
| Practice Address |
4646 Page Avenue Michigan Center MI 49254-1042 |
| Mailing Address |
2233 Tracy Rd Ste B Northwood OH 43619-1302 |
| Practice Telephone | 5177640400 |
| Practice Fax Number | 5177640475 |
| Mailing Telephone | 5177640400 |
| Mailing Fax Number | 5177640475 |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2020-04-22 |
| Authorized Official Name | CHRISTOPHER SCHOEN (VICE PRESIDENT) |
| Authorized Official Telephone | 4196541973 |
| Is Organization Subpart | Y |
| Parent Organization Name | PRESCRIPTION SUPPLY INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 5301000646 | MI | Suppliers |
| N | 333600000X | Pharmacy | 5301000646 | MI | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301000646 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | NCPDP/NABP | 2307254 | 01 |
| MI | DEA | AC3118797 | 01 |
| MI | 872503134 | 05 | |
| MI | BLUE CROSS BLUE SHIELD | 540C805637 | 01 |
| Other Name | Type Code |
|---|---|
| Commet Welcome Pharmacy | Other Name - Individual/Organization |
| LTC Welcome Pharmacy Michigan Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174532592 | Ltc Leonard LLC | Durable Medical Equipment & Medical Supplies | 303 W Prospect St, Jackson, MI 49203-4113 | 2006-08-05 |
| 1609885003 | Ltc Leonard LLC | Durable Medical Equipment & Medical Supplies | 826 W Bellevue St, Leslie, MI 49251-9302 | 2006-08-05 |
| 1942829395 | Ltc Leonard LLC | Pharmacy | 826 W Bellevue St, Leslie, MI 49251-9302 | 2020-04-15 |
| 1063031698 | Ltc Leonard LLC | Pharmacy | 303 W Prospect St, Jackson, MI 49203-4113 | 2020-04-14 |
| 1356960983 | Ltc Leonard LLC | Pharmacy | 4646 Page Ave, Michigan Center, MI 49254-1042 | 2020-04-14 |
| Street Address |
4646 PAGE AVENUE |
| City | MICHIGAN CENTER |
| State | MI |
| Zip Code | 49254-1042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083971436 | Kathleen Victoria Viola | Dermatology | 4304 Page Ave, Ste 200, Michigan Center, MI 49254 | 2012-04-23 |
| 1609931948 | Stephen Scott Tenniswood | Chiropractor | 4010 Page Ave # 104, Michigan Center, MI 49254 | 2006-12-27 |
| 1821199589 | Mary Lou Sommerfield | Physical Therapist | 4304 Page Ave Ste 100, Michigan Center, MI 49254 | 2006-09-26 |
| 1720134786 | Dawn E Wesenberg | Physician Assistant | 4328 Page Ave, Michigan Center, MI 49254 | 2007-01-25 |
| 1790906394 | John Gregory Palanci | Dentist | 4010 Page Avenue, Michigan Center, MI 49254-0497 | 2007-05-01 |
| 1801378971 | Tenniswood Chiropractic LLC | Chiropractor | 4010 Page Ave Ste 104, Michigan Center, MI 49254-1026 | 2018-09-05 |
| 1366583163 | Jason Max Ellis | Chiropractor | 4010 Page Ave, Ste 104, Michigan Center, MI 49254-1026 | 2007-02-12 |
| 1871725473 | Wendy Louise Hastings | Registered Nurse | 4328 Page Ave, Michigan Center, MI 49254-1036 | 2009-08-14 |
| 1386869899 | Kevin R Timm | Dentist | 4519 Page Ave, Michigan Center, MI 49254-1039 | 2007-04-17 |
| 1871642330 | Joseph A Mayo Jr Dc PC | Chiropractor | 4640 Page Ave, Michigan Center, MI 49254-1042 | 2007-01-10 |
| Find all providers in zip 49254 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| Find all providers with the same taxonomy | ||||
| City | MICHIGAN CENTER |
| Zip Code | 49254 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.