Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Family Pharmacy LLC

Organization Pharmacy · NPI 1386190247

Providence Family Pharmacy LLC is a Pharmacy in Glendale, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2016.

Licensed in
WI
In the registry since
2016
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2500 W Silver Spring Dr
Glendale, WI 53209-4218
Phone: (414) 885-0550
Fax: (414) 885-0552
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence 9428-42 (WI)
Pharmacy Taxonomy 333600000X
Long Term Care Pharmacy Taxonomy 3336L0003X

Record details

NPI number1386190247
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Abiola Okusanya — Manager · (414) 885-0550
Other names Providence Family Pharmacy Llc; Providence Family Pharmacy Llc
NPI enumeratedAugust 31, 2016
Last updated in NPPESFebruary 20, 2020
Certification dateFebruary 20, 2020
Mailing address2500 W Silver Spring Dr, Glendale, WI 53209-4218

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