NPI age
16 years
Enumerated 2009-06-03
● Active Type 2 · Organization
Providence Pharmacy Inc
Providence Pharmacy Inc is 1 of 1965 pharmacy organizations in Georgia.
Primary specialty
Pharmacy
Practice locations
2
1 secondary on file
Status
Active
No deactivations on record
Authorized official
Okpala
Ceo
Last NPPES update
2021-03-11
Source: monthly bulk 2026-05
How this organization compares
Across 1965 active pharmacy providers in Georgia.
NPI age
16 years
↓ 3 yr below median
Practice locations
2
1 secondary on file
Subspecialties
0
NPI lifetime · 2009 → 2026
2009-06Enumerated in NPPES
2009
2026
Where they practice
Primary practice location
180 W Broad St Ste A
Fairburn, GA 30213
Mailing address
180 W Broad St Ste A
Fairburn, GA 30213
Additional practice locations
1 secondary location on file with NPPES.
Location 2
180 W Broad St Ste A
Fairburn, GA 30213
Authorized official
Clement Emeka Okpala, PHARMD
Ceo
📞 6784892069
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Clement Okpala, PHARMD Pharmacist NPI 1326379280
Specialties
-
Pharmacy PrimaryA 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...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 054275159A |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
PROVIDENCE PHARMACY
Practice context
Multi-provider organization. 1 individual provider on file at this primary address. Plus 1 secondary practice location.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.