Active NPI
Proveri RX LLC
Doing business as Proveri Pharmacy Services
- Community/Retail Pharmacy
- Stockton, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- PROVERI RX LLC
- Doing business as
- Proveri Pharmacy Services
- Practice address
- 5713 N Pershing Ave # A3
Stockton, CA 95207-4942 - Phone
- (209) 488-7770
- NPI assigned
- May 4, 2020
- Last updated
- May 4, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Davis Thanh Tran
- Title
- Managing Owner
- Phone
- (209) 488-7770
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
5713 N Pershing Ave # A3
Stockton, CA 95207-4942
Mailing address
5713 N Pershing Ave # A3
Stockton, CA 95207-4942
Phone (209) 488-7770
Other names 1
- Proveri Pharmacy Services
National Provider Directory
National Provider Directory- Tax ID family
- Proveri Family Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Geriatric Pharmacist
- Stockton, CA
- NPI 1568866473
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588550400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1588550400000",
"number": "1821619537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5713 N PERSHING AVE # A3",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952074942",
"telephone_number": "209-488-7770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5713 N PERSHING AVE # A3",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952074942",
"telephone_number": "209-488-7770"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROVERI RX LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-05-04",
"last_updated": "2020-05-04",
"certification_date": "2020-05-04",
"status": "A",
"authorized_official_last_name": "TRAN",
"authorized_official_first_name": "DAVIS",
"authorized_official_middle_name": "THANH",
"authorized_official_title_or_position": "MANAGING OWNER",
"authorized_official_telephone_number": "209-488-7770"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Proveri Pharmacy Services",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Stockton, CA
- Kallie Provencher, BCBA
- Alaia Provencio
- Monique Nellie Provencio
- Proveri RX LLC (Proveri Pharmacy Services)
- Proveri RX LLC (Proveri Family Pharmacy)
- Elizabeth Rose Provost, RADT
- Barbara Kaye Prunty, LCSW
- PSC Stockton Outpatient Surgery Center, LLC
- Jennifer Elizabeth Ptak
- Bernadette Lourdes Torres Pua, NP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.