Organization · Type 2 NPI

Providentia LLC

Community/Retail Pharmacy · Tulsa, OK

NPI number 1710910237 Active

Practice location

4112 S Peoria Ave
Tulsa, OK 74105-7613

Fax (918) 743-5432

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	2-5706 (OK)
Long Term Care Pharmacy	3336L0003X	None listed

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 …

5 other providers at this address

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NPI record

NPI: 1710910237
Entity type: Organization (Type 2)
Issued: Jul 8, 2006
Last updated: Jul 28, 2020
Status: Active

Other names

<unavail>
Freeland Brown Pharmacy · doing business as
Freeland Brown Pharmacy · doing business as

Authorized official

Andrew Aaron Kohler
Owner/manager
(918) 743-4491

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1710910237

Providentia LLC's National Provider Identifier is 1710910237, issued on Jul 8, 2006. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Tulsa, OK. The record was last updated on Jul 28, 2020.