| NPI | 1821619537 |
|---|---|
| Doing Business As | PROVERI PHARMACY SERVICES |
| Entity Type | Organization |
| Authorized Contact | DAVIS THANH TRAN Managing Owner 209-488-7770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2020-05-04 |