| NPI | 1174008064 |
|---|---|
| Doing Business As | PROVINCE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MONA PATEL Pharmacy Manager 337-534-0615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2025-06-04 |