OrganizationActive
Providence Pharmacy Inc
NPI 1942436027 · Community/Retail Pharmacy · Fairburn, GA
Provider details
- NPI number
- 1942436027
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Clement Okpala, Ceo(678) 489-2069
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
180 W Broad St Ste a
Fairburn, GA 30213
Phone: (678) 489-2069
Fax: (678) 489-8627
Approximate (ZIP-level) locationGet directions
Mailing address
180 W Broad St Ste a
Fairburn, GA 30213
Other names (DBA / former)
- Doing business as
- Providence Pharmacy
Additional practice locations (1)
- 180 W Broad St Ste aFairburn, GA 30213Phone: (678) 489-2069Fax: (678) 489-8627
Registry dates
- Enumerated
- 2009-06-03
- Last updated
- 2021-03-11
- Certified
- 2021-03-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.