Providentia LLC
Providentia LLC is a healthcare organization registered as Community/Retail Pharmacy in Tulsa, OK, holding Type 2 (organization) NPI 1710910237 since 2006. The authorized official on file is Andrew Kohler, Owner/Manager.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1710910237 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Providentia LLC |
| Other name | <Unavail> |
| Practice address | 4112 S PEORIA AVE, Tulsa, OK, 74105 |
| Phone | 9187434491 |
| Fax | 9187435432 |
| Enumeration date | 2006-07-08 |
| Last updated in NPPES | 2020-07-28 |
Authorized official
| Name | Andrew Kohler |
|---|---|
| Title | Owner/Manager |
| Phone | 9187434491 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 333600000X | Pharmacy | Secondary | — | — |
| 3336L0003X | Long Term Care Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 2-5706 | OK |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100232760 B | Medicaid | OK | — |
| 100232760 A | Medicaid | OK | — |
| 2130880 | Other | — | PK |
Copy-ready billing details
Provider: Providentia LLC NPI: 1710910237 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 4112 S PEORIA AVE, Tulsa, OK, 74105
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1447262787 | Dennis Dufour | Individual | Pharmacist | Tulsa, OK |
| 1821327057 | Michael Dotson | Individual | Pharmacist | Tulsa, OK |
| 1265750905 | Lawrence Lofstrom | Individual | Pharmacist | Tulsa, OK |
| 1558617092 | Samuel Flegal | Individual | Pharmacist | Tulsa, OK |
| 1750637195 | Stephen Strong | Individual | Pharmacist | Tulsa, OK |
| 1821427428 | Matthew Corgill | Individual | Pharmacy Technician | Tulsa, OK |
Verify this record
Cross-check NPI 1710910237 against the authoritative CMS record: view Providentia LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Who is the authorized official for Providentia LLC?
What is the NPI number for Providentia LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-07-28.