# PROVERI RX LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Proveri Pharmacy Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457913808
- **Authorized official:** DR. DAVIS TRAN PHARMD (MANAGER)
- **Authorized official phone:** (805) 300-3584

## Contact information

- **Practice address:** 5713 N PERSHING AVE \# A3, STOCKTON, CA 95207-4942
- **Practice address phone:** (888) 821-4174
- **Mailing address:** 5713 N PERSHING AVE \# A3, STOCKTON, CA 95207-4942

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 07/06/2019
- **Last updated:** 05/04/2020