Provencio, Victor

Provencio, Victor is an individual health care provider with primary practice located at 865 N Arizola Rd , Casa Grande AZ 85122-6011. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Provencio, Victor can be contacted via phone (520) 836-3446.

Contact Information

Primary practice address
865 N Arizola Rd Casa Grande AZ 85122-6011
Fax: (520) 836-8807
Website:

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 6049 Arizona

Profile Details

NPI number 1679649958
LBN Legal business name Provencio, Victor
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2006
Last updated Nov 17th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679649958 NPPES
Arizona Other 6049 LICENSE

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