| NPI | 1447728423 |
|---|---|
| Doing Business As | PROVIDENCE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | EMMANUEL ORUSAKWE President 832-623-7554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2018-11-07 |