<Unavail>

LBN: Providentia Llc
<Unavail> is an health care organization with primary practice located at 1507 W 51St St , Tulsa OK 74107-8041. The organization recently has 3 registered licenses in different health care specialties including 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) 446-1404, or through Dotson, Michael via phone (918) 688-9149.

Contact Information

Primary practice address
1507 W 51St St Tulsa OK 74107-8041
Phone: (918) 446-1404
Fax: (918) 794-1610
Website:
Map and Directions
Authorized official contact:
Name: Dotson, Michael BS PHARMACY
Phone: (918) 688-9149

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 2-6651 Oklahoma
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1700965472
LBN Legal business name Providentia Llc
DBA Doing business as <Unavail>
Authorized official Dotson, Michael BS PHARMACY
Entity Organization
Organization subpart 1 No
Enumeration date Nov 3rd, 2006
Last updated Nov 8th, 2016 - about 10 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 1700965472 NPPES
Oklahoma MEDICAID 100235670G
Oklahoma Other 2144892

Popular Providers