Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1265703128 Individual Practitioner Female Practitioner

Detra Elaine Provost , RPH

Pharmacist • Evans, GA

Professional Overview & Biography Verified Profile Summary

Detra Provost, RPH is a registered healthcare professional specializing in Pharmacist in Evans, GA. Practice services are available at 4223 WASHINGTON RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4223 Washington Rd

Evans, GA 308093069

Telephone 7068690937
Fax 7069939781
Associated Practice Facility / Clinic
🏢 Georgia Cvs Pharmacy Llc Facility NPI 1114949906

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Evans, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 6.0 Yrs
Regional Practice Density
46 Specialists

Practicing in Evans, GA (8508 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License GA RPH18214

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.

Pharmacist

NUCC Taxonomy Code: 183500000X

State License SC 8706

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.

Pharmacist

NUCC Taxonomy Code: 183500000X

State License TX 32754

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1760251912

Doctor of Pharmacy (Pharm.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active January 24, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location January 24, 2012

Registered at 4223 WASHINGTON RD, EVANS, GA 308093069 (Tel: 7068690937)

📍
Updated Business Mailing Address January 24, 2012

Registered at 114 ABERDEEN DR, AIKEN, SC 298037100 (Tel: 8036493603)

👤
Provider Name / Credentials Updated January 24, 2012

Recorded as DETRA PROVOST, RPH

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 24, 2012

Pharmacist (License #RPH18214 in GA)

🟢
Initial NPI Registration & Enumeration January 24, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1265703128
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 24, 2012
Last Update: January 24, 2012
Sole Proprietor: No

Mailing Address

114 Aberdeen Dr

Aiken, SC 298037100

Phone: 8036493603

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.