<Unavail>
LBN: Providentia Llc
<Unavail> is an health care organization with primary practice located at 4112 S Peoria Ave , Tulsa OK 74105-7613. 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) 743-4491, or through Kohler, Andrew Aaron via phone (918) 743-4491.
Contact Information
Primary practice address
4112 S Peoria Ave
Tulsa OK 74105-7613
Phone: (918) 743-4491
Fax: (918) 743-5432
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 2-5706 | Oklahoma |
| Suppliers / Long Term Care Pharmacy | 3336L0003X |
Profile Details
| NPI number | 1710910237 |
|---|---|
| LBN Legal business name | Providentia Llc |
| DBA Doing business as | <Unavail> |
| Authorized official | Kohler, Andrew Aaron |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 8th, 2006 |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710910237 | NPPES |
| Oklahoma | MEDICAID | 100232760 B | |
| Oklahoma | MEDICAID | 100232760 A | |
| Oklahoma | Other | 2130880 |
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