PROVIDENTIA LLC (NPI# 1700965472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700965472 |
| Entity Type | Organization |
| Organization Name | PROVIDENTIA LLC |
| Other Organization Name | FREELAND BROWN PHARMACY NO. 2 |
| Practice Address |
1507 W 51st St Tulsa OK 74107-8041 |
| Mailing Address |
4112 S Peoria Ave Tulsa OK 74105-7613 |
| Practice Telephone | 9184461404 |
| Practice Fax Number | 9187941610 |
| Mailing Telephone | 9187434491 |
| Mailing Fax Number | 9187435432 |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2016-11-08 |
| Authorized Official Name | MICHAEL DOTSON (OWNER) |
| Authorized Official Telephone | 9186889149 |
| Authorized Official Credential | BS PHARMACY |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2-6651 | OK | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100235670G | 05 | |
| PK | 2144892 | 01 |
| Other Name | Type Code |
|---|---|
| Freeland Brown Pharmacy No. 2 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710910237 | Providentia LLC | Durable Medical Equipment & Medical Supplies | 4112 S Peoria Ave, Tulsa, OK 74105-7613 | 2006-07-08 |
| 1295101632 | Providentia LLC | Durable Medical Equipment & Medical Supplies | 4227 Southwest Blvd, Crystal City Shopping Center, Tulsa, OK 74107-6522 | 2015-08-20 |
| Street Address |
1507 W 51ST ST |
| City | TULSA |
| State | OK |
| Zip Code | 74107-8041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659323517 | Bobby Alfred Sturgeon Jr. | Pharmacist | 1507 W 51st St, Tulsa, OK 74107-8041 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508493784 | Squareone Compassion Inc | Clinic/Center | 5323 South 65th West Avenue, Tulsa, OK 74107 | 2020-03-26 |
| 1649772476 | Lauren Michele Rogers | Student in an Organized Health Care Education/Training Program | 1111 W. 17th St., Barson 241, Tulsa, OK 74107 | 2018-03-07 |
| 1336641828 | Frank Patrick Goodman | Student in an Organized Health Care Education/Training Program | 2345 Sw Blvd, Tulsa, OK 74107 | 2018-03-01 |
| 1659827269 | Careatc - America Waste | Clinic/Center | 23322 Southwest Blvd, Tulsa, OK 74107 | 2016-09-01 |
| 1538530886 | Jeremy Michael Bowles | Pharmacist | 4227 Southwest Boulevard, Tulsa, OK 74107 | 2015-10-13 |
| 1760725865 | Nicholas Alexander | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd., Osu Health Care Center, Tulsa, OK 74107 | 2013-03-27 |
| 1295095321 | Robert Steven Wedding | Counselor | 6033 S. 31 St. West Ave., Tulsa, OK 74107 | 2012-05-23 |
| 1295911451 | American Current Care P.a. | Clinic/Center | 5682 W Skelly Drive, Tulsa, OK 74107 | 2008-01-17 |
| 1821200072 | Leeca Jenkins | Counselor | 2007 W. 57th St, Tulsa, OK 74107 | 2007-05-03 |
| 1477670552 | Occupational Health Centers of The Southwest, P.a. | Clinic/Center | 5682 W. Skelly Drive, Tulsa, OK 74107 | 2007-03-23 |
| Find all providers in zip 74107 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | 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 health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962063933 | Walgreen Co | Pharmacy | 1145 S Utica Ave Ste G1, Tulsa, OK 74104-4022 | 2019-06-21 |
| 1952888356 | Genscripts LLC | Pharmacy | 10827 S Memorial Dr Ste D, Tulsa, OK 74133-7361 | 2018-07-27 |
| 1063824589 | Rx Holdings LLC | Pharmacy | 11414 E 51st St Ste A, Tulsa, OK 74146-5800 | 2014-06-02 |
| 1508102609 | Insync Life Care LLC | Pharmacy | 6310 East 102nd Street, Tulsa, OK 74137-7061 | 2012-12-17 |
| 1235315250 | Oklahoma Cvs Pharmacy LLC | Pharmacy | 7437 S Olympia Ave W, Tulsa, OK 74132-1838 | 2008-01-22 |
| 1366526022 | Walgreen Co | Pharmacy | 5046 S Sheridan Rd, Tulsa, OK 74145-5714 | 2006-10-25 |
| 1225121338 | Moore Pharmacy Service; LLC | Pharmacy | 11414 E. 51st Street, Unit A, Tulsa, OK 74146-5821 | 2006-10-02 |
| 1134233117 | Genscripts LLC | Pharmacy | 3980 S Hudson Ave, Tulsa, OK 74135-5608 | 2006-08-18 |
| 1699786723 | Cfp Acquisitions, Inc. | Pharmacy | 6136 E 51st St, Tulsa, OK 74135-7704 | 2006-08-11 |
| 1033126925 | Walgreen Co | Pharmacy | 10018 S Yale Ave, Tulsa, OK 74137-6016 | 2006-08-02 |
| Find all providers in TULSA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.