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PROVIDENCE PHARMACY
NPI 1154733905
Pharmacy - Community/Retail Pharmacy in Las Vegas, NV

Active since May 28, 2014
1729 E CHARLESTON BLVD STE F, LAS VEGAS, NV 89104(702) 778-3072(702) 778-0512 Get Directions Write a Review

NPPES record last updated: September 21, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Providence Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE PHARMACY (NPI 1154733905) is a healthcare organization registered as a community/retail pharmacy in Las Vegas, Nevada and active in the NPI registry since May 2014. The organization lists Modupe Irorobeje, Chief Pharmacist, as its authorized official.

NPPES Registry Identity

NPI1154733905
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameDIVINE PROVIDENCE INC
Location Address1729 E CHARLESTON BLVD STE FLas Vegas, NV 89104-1986
Mailing Address1729 E Charleston Blvd Ste FLas Vegas, NV 89104-1986 · (702) 778-3072 · Fax (702) 778-0512
Phone(702) 778-3072
Fax(702) 778-0512
Organization SubpartNo
Authorized OfficialModupe IrorobejeChief Pharmacist · (702) 778-3072
Enumeration DateMay 28, 2014
Last NPPES UpdateSeptember 21, 2016
✔ NPI 1154733905 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in NV · PH03196
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedPharmacyTaxonomy 333600000X
1729 E CHARLESTON BLVD STE F, Las Vegas, NV 89104
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Other Names 1

Doing Business AsProvidence Pharmacy

Other Identifiers 2

Medicaid1154733905NV
Other2147176Pk

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DIVINE PROVIDENCE INC
Durable Medical Equipment & Medical Supplies
1729 E CHARLESTON BLVD STE F
LAS VEGAS, NV 89104
Clark County (954) 663-1759

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Divine Providence Inc's NPI number?

The NPI number for Divine Providence Inc is 1154733905. It was assigned to this organization in the NPPES registry on May 28, 2014. The provider is doing business as Providence Pharmacy.

Where is Divine Providence Inc located?

Divine Providence Inc is located at 1729 E Charleston Blvd Ste F, Las Vegas, NV 89104. The listed phone number is (702) 778-3072.

What is Divine Providence Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

When was this NPI record last updated?

The NPPES record for Divine Providence Inc was last updated on September 21, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.