Provider Demographics
NPI:1003491697
Name:LTC PHARMACY SOLUTIONS LLC
Entity Type:Organization
Organization Name:LTC PHARMACY SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:W
Authorized Official - Last Name:KLAASMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-525-1251
Mailing Address - Street 1:32 GRANT 531
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72150-8212
Mailing Address - Country:US
Mailing Address - Phone:501-258-2477
Mailing Address - Fax:870-942-4303
Practice Address - Street 1:3425 N 190TH PLZ
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-3553
Practice Address - Country:US
Practice Address - Phone:402-525-1251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-15
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy