OrganizationActive
Providence Pharmacy & Wellness
NPI 1245080860 · Pharmacy · Glendale, WI
Provider details
- NPI number
- 1245080860
- Entity type
- Organization
- Primary specialty
- PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Rostian Akpor-Mensah, Managing Pharmacist(414) 305-7131
Specialties & taxonomies
Suppliers
Profile Score
Established profile(57/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2500 W Silver Spring Dr
Glendale, WI 53209-4218
Phone: (414) 400-0104
Fax: (414) 400-0107
Street-level locationGet directions
Mailing address
1613 E Menlo Blvd
Shorewood, WI 53211-2249
Registry dates
- Enumerated
- 2024-03-26
- Last updated
- 2024-03-26
- Certified
- 2024-03-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.