<Unavail>

LBN: Providentia Llc
<Unavail> is an health care organization with primary practice located at 4227 Southwest Blvd Crystal City Shopping Center, Tulsa OK 74107-6522. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Providentia Llc can be contacted via phone (918) 986-8644, or through Kohler, Andrew Aaron via phone (918) 743-4491.

Contact Information

Primary practice address
4227 Southwest Blvd Crystal City Shopping Center Tulsa OK 74107-6522
Phone: (918) 986-8644
Fax: (918) 986-8655
Website:
Map and Directions
Authorized official contact:
Name: Kohler, Andrew Aaron
Phone: (918) 743-4491

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 2-7324 Oklahoma
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PD07681 Arkansas
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1295101632
LBN Legal business name Providentia Llc
DBA Doing business as <Unavail>
Authorized official Kohler, Andrew Aaron
Entity Organization
Organization subpart 1 No
Enumeration date Aug 20th, 2015
Last updated Jul 28th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1295101632 NPPES
Oklahoma MEDICAID 100232760 F
Oklahoma Other 2153603

Popular Providers