Freeland Brown Pharmacy

LBN: Providentia Llc
Freeland Brown Pharmacy 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:
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
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 Freeland Brown Pharmacy
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710910237 NPPES
Oklahoma MEDICAID 100232760 B
Oklahoma MEDICAID 100232760 A
Oklahoma Other 2130880

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