Organization
PROVERI RX LLC
Active
Other names
Proveri Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAVIS THANH TRAN PHARMD (OWNER)
(805) 300-3584
Entity
Organization
Contact information
Practice address
4873 WEST LN STE B, STOCKTON, CA 95210-4548
(805) 300-3584
Mailing address
5713 N PERSHING AVE # A3, STOCKTON, CA 95207-4942
(209) 488-7770
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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