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MRS. DETRA ELAINE PROVOST RPH NPI 1265703128


NPI Information

NPI: 1265703128
Provider Name: MRS. DETRA ELAINE PROVOST, RPH
Classification: Pharmacist - 183500000X
Entity Type: Individual
Address:
4223 WASHINGTON RD
EVANS, GA
ZIP 30809
Phone: (706) 869-0937
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MRS. Detra Elaine Provost, RPH is a pharmacist in Evans, GA. The provider is an individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. MRS. Detra Elaine Provost, RPH NPI is 1265703128. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4223 WASHINGTON RD
EVANS, GA
ZIP 30809-069
Phone: (706) 869-0937
Fax: (706) 993-9781

The enumeration date for this NPI number is 1/24/2012 and was last updated on 1/24/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1183500000XPharmacist8706SOUTH CAROLINANo
2183500000XPharmacist32754TEXASNo
3183500000XPharmacistRPH18214GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.