Providence Pharmacy Inc is an authorized DME supplier for medicare equipments and products.
Providence Pharmacy Inc is a Community/Retail Pharmacy in Fairburn, Georgia. It is located at 180 W Broad St Ste A, Fairburn and it's customer support contact number is 678-489-2069. The authorized person of Providence Pharmacy Inc is Clement Emeka Okpala, PHARMD who is Ceo of the pharmacy and his contact number is 678-489-2069.Providence Pharmacy Inc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance. Providence Pharmacy Inc is a 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 dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Pharmacy Details:
Providence Pharmacy Inc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
Name:
Providence Pharmacy Inc
Type:
Community/Retail Pharmacy
Location:
180 W Broad St Ste A, Fairburn, Georgia, 30213
Phone:
678-489-2069
Fax:
678-489-8627
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
Name:
Clement Emeka Okpala
Credentials:
PHARMD
Position:
Ceo
Contact Number:
678-489-2069
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
NPI Number:
1942436027
NPI Enumeration Date:
03 Jun, 2009
NPI Last Update On:
11 Mar, 2021
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Providence Pharmacy Inc are as mentioned below.
Specialization
License Number
State
Status
Community/Retail Pharmacy
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
054275159A
Medicaid
Georgia
Medicare Enrollment:
Providence Pharmacy Inc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
PAC ID:
Enrollment ID:
Org Name
Medicare Entity Type
4587859459
O20101117000936
Providence Pharmacy Inc
DME SUPPLIER - PHARMACY
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
180 W Broad St Ste A, Fairburn, Georgia
Zip:
30213
Phone Number:
678-489-2069
Fax Number:
678-489-8627
Patients can reach Providence Pharmacy Inc at 180 W Broad St Ste A, Fairburn, Georgia or can call on customer care at 678-489-2069.
Comments/ Reviews:
*Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.