| Mrs Detra Elaine Provost, RPH | |
|
4223 Washington Rd, Evans, GA 30809-3069 | |
| (706) 869-0937 | |
| (706) 993-9781 |
| Full Name | Mrs Detra Elaine Provost |
|---|---|
| Gender | Female |
| Speciality | Pharmacist |
| Location | 4223 Washington Rd, Evans, Georgia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265703128 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 183500000X | Pharmacist | RPH18214 (Georgia) | Primary |
| 183500000X | Pharmacist | 8706 (South Carolina) | Secondary |
| 183500000X | Pharmacist | 32754 (Texas) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Detra Elaine Provost, RPH 114 Aberdeen Dr, Aiken, SC 29803-7100 Ph: (803) 649-3603 | Mrs Detra Elaine Provost, RPH 4223 Washington Rd, Evans, GA 30809-3069 Ph: (706) 869-0937 |
Katie Guyton, PHARM.D. Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 4310 Washington Rd, Evans, GA 30809 Phone: 706-860-4179 | |
Diana Dang Tran, PHARMD Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 4274 Washington Rd, Evans, GA 30809 Phone: 706-650-5040 | |
Dr. Joshua Nathaniel Nesbitt, PHARMD Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 5119 Washington Rd, Evans, GA 30809 Phone: 706-650-1460 | |
Linh Bao Nguyen, PHARMD Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 4469 Washington Rd, Evans, GA 30809 Phone: 706-854-1516 Fax: 706-854-1507 | |
Epifanio Ramos, PHARMACIST Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 991 Windmill Pkwy, Evans, GA 30809 Phone: 706-210-0340 | |
Mr. Randall Timothy Plant, BS Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 4310 Washington Rd, Evans, GA 30809 Phone: 706-860-4179 | |
Thao Tran, Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 1044 Furys Ferry Rd, Evans, GA 30809 Phone: 706-860-3945 |