Providentia Llc is a Pharmacy in Tulsa, Oklahoma. Providentia Llc practices all healthcare services and medical treatments related to Pharmacy. The NPI Number for Providentia Llc is 1700965472. The last update date is 2016-11-08.
Providentia Llc's current location address is 4112 S Peoria Ave, Tulsa, Oklahoma. You can contact this provider via phone number 9187434491 and fax number 9187435432. The mailing address for Providentia Llc is 4112 S Peoria Ave, Tulsa, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Providentia Llc |
|---|---|
| Address | 4112 S Peoria Ave, Tulsa, Oklahoma |
| Phone Number | 9187434491 |
| Fax Number | 9187435432 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Dotson Michael |
| Credentials | BS PHARMAC |
| Telephone Number | 9186889149 |
NPI Number Detail
| NPI Number | 1700965472 |
|---|---|
| Provider Enumeration Date | 2006-11-03 |
| Last Updated Date | 2016-11-08 |
Provider Mailing Address Detail
| Address | 4112 S Peoria Ave |
|---|---|
| City | Tulsa |
| State | Oklahoma (OK) |
| Post Code | 741057613 |
| Phone Number | 9187434491 |
| Fax Number | 9187435432 |
Provider's Primary Taxonomy Detail
| Speciality | Pharmacy |
|---|---|
| Taxonomy | 333600000X |
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Definition: A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense presc |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 100235670G | OK | -- | |
| 2144892 | PK |
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What is the unique 10-digit identification code issued to Providentia Llc by the Centers for Medicare & Medicaid Services?
The Providentia Llc has been assigned the NPI (National Provider Identifier) 1700965472 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Providentia Llc?
The Providentia Llc is situated at 4112 S Peoria Ave, in the city of Tulsa, state of OK, with the zip code 741057613.
What is the Providentia Llc's area of specialization and corresponding taxonomy classification?
The Providentia Llc's specialty field is Pharmacy, and it falls under the taxonomy code 333600000X, which categorizes healthcare providers based on their specialties.
When did the Providentia Llc receive its 1700965472?
The Providentia Llc was issued its 1700965472 on 2006-11-03, which is the date when the organization was assigned this unique identifier.
As of what date were the details pertaining to Providentia Llc last refreshed?
The information related to the Providentia Llc, including its address, specialty, and other relevant details, was last updated on 2016-11-08.
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