Divine Providence Inc

NPI 1154733905 - Pharmacy - 3336C0003X

NPI Details
NPI 1154733905
Enumeration Date 05/28/2014
Last Updated 08/13/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name MODUPE MODUPE
Position CHIEF PHARMACIST
Phone (702) 778-3072
Fax (702) 778-0512
Practice Location
1729 E CHARLESTON BLVD STE F
LAS VEGAS NV, 89104-1986, US
Phone (702) 778-3072
Fax (702) 778-0512
Business Location
1729 E CHARLESTON BLVD STE F
LAS VEGAS NV, 89104-1986, US
Phone (702) 778-3072
Fax (702) 778-0512
Toxanomy
Taxonomy Code 3336C0003X
License State Nevada
License Number PH03196
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According to our database, Divine Providence Inc NPI is 1154733905, taxonomy code is 3336C0003X and license number is PH03196, license state is located at Nevada. Divine Providence Inc physically located at 1729 E Charleston Blvd Ste F, Las Vegas NV, 89104-1986. NPI Number 1033115704 has the healthcare provider type.

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1154733905 NPI number is provided on an as is basis without warranty of any kind. 1154733905 is maintained by the National Plan & Provider Enumeration System. The contents of Divine Providence Inc are for informational purposes only.