Provider Demographics
NPI:1447632096
Name:LTCARERX CONSULTING LLC
Entity type:Organization
Organization Name:LTCARERX CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:DEANN
Authorized Official - Last Name:LEYES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH CGP
Authorized Official - Phone:612-618-1389
Mailing Address - Street 1:15430 FRANCES LN NW
Mailing Address - Street 2:
Mailing Address - City:MILTONA
Mailing Address - State:MN
Mailing Address - Zip Code:56354-8320
Mailing Address - Country:US
Mailing Address - Phone:612-618-1389
Mailing Address - Fax:
Practice Address - Street 1:15430 FRANCES LN NW
Practice Address - Street 2:
Practice Address - City:MILTONA
Practice Address - State:MN
Practice Address - Zip Code:56354-8320
Practice Address - Country:US
Practice Address - Phone:612-618-1389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1162513336L0003X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy