Providence Pharmaceuticals Inc
Community/Retail Pharmacy
15435 S Western Ave, Ste 100 C, Gardena
California, 90249-4323
310-353-2695 310-353-2696
Providence Pharmaceuticals Inc is a Community/Retail Pharmacy in Gardena, California. It is located at 15435 S Western Ave, Ste 100 C, Gardena and it's customer support contact number is 310-353-2695. The authorized person of Providence Pharmaceuticals Inc is Diana Choi who is President of the pharmacy and his contact number is 310-353-2699. Active license number of Providence Pharmaceuticals Inc is PHY51680 for Community/Retail Pharmacy in California. Providence Pharmaceuticals Inc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Providence Pharmaceuticals Inc is 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.
Pharmacy Details:
Providence Pharmaceuticals Inc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Providence Pharmaceuticals Inc |
| Type: | Community/Retail Pharmacy |
| Location: | 15435 S Western Ave, Ste 100 C, Gardena,
California, 90249-4323 |
| Phone: | 310-353-2695 |
| Fax: | 310-353-2696 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Diana Choi |
| Position: | President |
| Contact Number: | 310-353-2699 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1639180227 |
| NPI Enumeration Date: | 10 Aug, 2006 |
| NPI Last Update On: | 21 Feb, 2017 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Providence Pharmaceuticals Inc are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | PHY51680 | California | Primary | |
| Pharmacy | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 2143869 | Other | | Pk |
Medicare Enrollment:
Providence Pharmaceuticals Inc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 2860704889 | O20150706001304 | Providence Pharmaceuticals Inc | DME SUPPLIER - PHARMACY |
| 2860704889 | O20151012000348 | Providence Pharmaceuticals Inc | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
Products Available:
Providence Pharmaceuticals Inc has following products available for sale under medicare.
| Products: |
|---|
| • Blood Glucose Monitors & Supplies: Non-mail Order | • Canes & Crutches |
| • Commodes, Urinals, & Bedpans | • Diabetic Shoes & Inserts: Custom Fabricated |
| • Diabetic Shoes & Inserts: Prefabricated | • Orthoses: Off-the-shelf |
| • Orthoses: Prefabricated | • Ostomy Supplies |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 15435 S Western Ave, Ste 100 C
Gardena, California |
| Zip: | 90249-4323 |
| Phone Number: | 310-353-2695 |
| Fax Number: | 310-353-2696 |
Patients can reach Providence Pharmaceuticals Inc at
15435 S Western Ave, Ste 100 C, Gardena, California or can
call on customer care at 310-353-2695.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.